^.HY!--!! & CAJjjJHE BABY 



FRANCIS TWfiDDELL M.D. 





Class TT 
Book i 






Copyright^ 



COPYRIGHT DEPOSIT. 



/ 



HOW TO TAKE 
CARE OF THE BABY 



A MOTHER'S GUIDE AND 
MANUAL FOR NURSES 



By 
FRANCIS TWEDDELL, M.D. 

ALUMNUS BELLEVUE HOSPITAL, NEW YORK, FELLOW OF THE 

NEW YORK ACADEMY OF MEDICINE, LATE PHYSICIAN 

TO THE BABIES* HOSPITAL DISPENSARY, NEW YORK 



THIRD EDITION 
REVISED AND ENLARGED 



THE BOBBS-MERRILL COMPANY 
PUBLISHERS 



Copyright 1913-1915 
The Bobbs- Merrill Company 







PRESS OF 

BRAUNWORTH & CO. 

BOOKBINDERS AND PRINTERS 

BROOKLYN. N. Y. 



NOV -8 19/5 



CLA416269 

1^ Jt\ I 



TO 
JOSEPHINE HEMENWAY, M.D. 

HOUSE PHYSICIAN OF THE BABIES' HOSPITAL, NEW YORK, SINCE 1906 

THIS LITTLE BOOK IS DEDICATED 

AS A MARK OF ESTEEM, AND GRATITUDE FOR MANY FAVORS. 

BY THE AUTHOR 



PREFACE TO THE FIRST EDITION 



In presenting this little book to the public, the author's 
aim is to give simple, clear, and complete directions, espe- 
cially as regards nursing and artificial feeding of infants, 
and disorders of digestion. 

The chapters are complete in themselves, and the head- 
ings have been so arranged as to render a search for 
information on any subject an easy matter. 

F. T. 
71 West 68th Street, 
New York. 

July 12th, 1911. 



CONTENTS 



PACE 



The Nursery 1 

The Baby's Bed 3 

Clothing 4 

List of Clothing 6 

Care of Napkins 7 

How to Lift the Baby 7 

Bathing 3 

Care of Eyes 13 

Care of Genitals 13 

Airing 14 

Exercise 16 

Sleep 17 

Nursing 21 

Wet-Nursing 32 

Weaning 36 

Artificial Feeding 39 

Additional Food During the First Year 62 

Protein Milk 63 

Peptonized Milk B 65 

Buttermilk 65 

Sterilization and Pasteurization of Milk 66 

Diet from the Second to the Tenth Year 68 

Loss of Appetite 73 

Forbidden Articles a£ Food 77 

Stools 77 

Indigestion 80 

Colic and Wind 85 

Vomiting 86 

Diarrhea 90 

Constipation 95 

Malnutrition and Marasmus 100 

Colds 103 

Bronchitis 106 

Hiccough 108 

Spasmodic Croup 108 



CONTENTS— Continued 

PAGE 

Ear-ache 109 

Sprue or Thrush 110 

Enlarged Glands Ill 

Adenoids Ill 

Tonsils 112 

Worms 112 

Night Terrors 113 

The Retention of Urine 114 

Jaundice 115 

The Temperature 115 

Examination of Throat 116 

Training of Bowels and Bladder 118 

Development 120 

Dentition 123 

Vaccination 128 

Circumcision 128 

The Cry 129 

Kissing and Playing with Babies 130 

Toys 131 

Bad Habits 132 

Milk in Infants' Breasts 134 

Accidents 134 

Convulsions 136 

Rickets 138 

Scurvy 139 

Pneumonia 140 

The Sickroom in Contagious Diseases 142 

Contagious Diseases 145 

Diseases of the Skin 151 

Food Recipes 154 

Measures 158 

Common Remedies 158 

Injections, Suppositories and Irrigations 160 

Don't 162 



HOW TO TAKE CARE OF 
THE BABY 



How to Take Care of 
the Baby 



THE NURSERY 

Location and Furnishings. — The nursery should be 
a large, airy room, above the ground floor, and with a 
southern exposure. Plenty of light, air and sunshine 
are essential to the baby's welfare. The furniture ought 
to be of the simplest, with no upholstery; the bed of 
enamelled iron or brass, and the draperies of light, wash- 
able materials. 

At the windows, both light and dark shades are needed, 
as the new-born infant is very susceptible to' light and 
therefore for the first few weeks the nursery should be 
kept darkened. 

The floor should not be carpeted, only a few light 
rugs placed where they are most needed, and care must 
be taken to keep these scrupulously clean. No stationary 
washbasins or plumbing of any kind must be allowed 
in the room. Furniture and floors should be wiped daily 
with damp cloths, and not dusted. 

Ventilation. — Particular attention must be paid to 
the ventilation, which can be secured at all times without 
a draft by means of a window board about five or six 
inches wide and long enough to fit the window exactly 
when the lower sash is raised to insert it. This admits 



2 HOW TO TAKE CARE OF THE BABY 

of a free passage of air upward into the room between 
the upper and lower sashes. 

In addition to this, the nursery should always be aired 
for at least an hour, morning and evening, after the 
bath, and just before going to bed; while this is being 
done, the baby must be taken into another room. 

No cooking, washing or drying of clothes should 
ever be permitted in the nursery at any time. 

Heating. — The system of hot water heating is un- 
doubtedly the best, and open fires when the weather is 
not very cold, but it is not always possible to obtain these. 
When steam or hot air is used, a pan of water should 
always be kept in the room to prevent excessive dryness 
of the atmosphere. Iron, gas, or oil stoves are the worst 
methods of heating, and ought never to be used. 

The Temperature. — The temperature of the room 
should be kept at about 70° F. by day, and at night never 
above 64 °F. even for a young baby; and as the child 
grows older, this can be gradually reduced until he be- 
comes accustomed to sleeping in a cold room. The 
window should be partly opened top and bottom at night, 
more or less, according to the weather, beginning from 
the time the child is two or three months old, if the 
temperature outside is not freezing. After the age of 
six months it should be opened in any weather, unless 
the child is delicate or ill. 

Care must be taken that the cold air does not blow 
directly on the baby, and that he has sufficient covering. 
With the exception of the mother or nurse, no one else 
should be allowed to sleep in the room. 

Danger of Too Much Heat. — Although it is essential 
to keep a child thoroughly warm, a great deal of harm 
can be done by keeping the nursery too hot. A child 
kept in hot rooms loses his appetite, becomes pale, per- 
spires easily, loses weight, and is subject to colds and 
indigestion. 



A MOTHER'S GUIDE 3 

Lighting. — No gas should be allowed to burn in the • 

nursery at night, and where there is no electric light, 
a wax night light should be used. 

Screens. — In summer, the windows of the nursery 
should be fitted with screens to keep out flies and mos- 
quitoes. Some babies are badly poisoned by mosquito 
bites, and one kind of mosquito can give the child ma- 
laria. 

Flies are dangerous because they may alight on the 
nipple of the baby's bottle or on the food, and a fly's 
feet can bring germs from wherever their last resting 
place may have been. Contagious diseases and other ail- 
ments are often transported in this way. 

THE BABY'S BED 

Bed and Bedding. — From the first a baby ought to 
have a separate bed of brass or enamelled iron which 
does not rock. The mattress should be of hair, and 
covered with an India-rubber sheet, then a cotton pad, 
and, finally a cotton (not a linen) sheet. For the first 
few weeks it is better for the infant to lie with his head 
low; a pad doubled under the head is sufficient; after 
this a small hair pillow is best, as feathers are too heat- 
ing. 

For coverings use a cotton sheet, warm woolen blan- 
kets, and when necessary, an eiderdown quilt. Have all 
coverings sufficiently warm, but light, and never keep 
him so hot that he perspires, as this is very weakening, 
and predisposes him to catching cold. If the feet are 
cold, a hot water bottle covered with a flannel bag should 
be placed in the bed near them, but take great care that 
it is not hot enough to burn the skin. 

Care of the Bedding. — All the bedding should be 
thoroughly aired and exposed to the sun every day, and 
the mattress and pillows shaken and turned. Sheets 



4 HOW TO TAKE CARE OF THE BABY 

and pads which have become wet or soiled should never 
be used a second time before washing, and care must 
be taken that they are thoroughly dry before making 
up the bed. 

Location of Crib. — The crib should be placed in 
such a manner that the light will not fall directly on the 
baby's eyes, and never between two windows or doors, 
or where a draft can blow directly over him. A screen 
placed around the bed is very useful in preventing this. 

CLOTHING 

General Directions. — The clothing for infants should 
be extremely simple, and moderately snug-fitting, so 
that there shall be no wrinkles to hurt the baby, and at 
the same time they should be loose enough to admit of 
free circulation and unhampered movements. 

Underwear. — In winter, wool is the best material 
for undergarments for babies, but with an admixture of 
silk or cotton, and not of the heaviest grade, as too thick 
garments will make a child delicate and very sensitive 
to changes, and are quite unnecessary even in winter if 
the nursery is kept at the proper temperature. When 
the baby is taken out for an airing, changes in tempera- 
ture must be met by sufficient outer wraps. 

In summer the underwear should be of the lightest 
grade of silk and wool, or cotton and wool. 

For the first two months, an infant should wear a 
plain flannel band rolled smoothly about the abdomen 
and sewn, not fastened with safety pins. This is later 
replaced by the knitted band with straps over the shoul- 
ders. Over this, in winter, is worn the woolen under- 
vest with long sleeves and high neck. The diaper is 
then pinned to the bottom of the vest to prevent the 
shirt from working up about the body, and also to keep 
the diaper from slipping down. Diapers should be of 



A MOTHER'S GUIDE 5 

bird's-eye cotton, or of stockinet, but not of linen. In 
summer, the undervest can be omitted, and the diaper 
pinned to the band. Rubber diapers should never be 
used except for a short time when traveling, as they 
act like poultices when wet. 

Foot Covering. — The baby's feet should be covered 
with knitted or crocheted bootees, and care taken that 
the feet are always perfectly warm. In summer the 
bootees are replaced by soft kid ones, and thin socks 
worn under them next to the skin. 

Outer Garments.— The flannel skirt should be sup- 
ported from the shoulders, and not pinned about the 
body on a tight band; then a simple little dress, prefer- 
ably of nainsook, and if the weather is very cold, either 
a knitted or a flannel jacket. For the first three weeks, 
a soft cashmere or woolen shawl should be wrapped 
about the baby, covering the head as well. 

Coat, Cap and Mittens. — When the baby is taken 
for an airing, his coat should be very warm and soft, 
but not heavy, and the cap preferably of silk with an 
interlining of flannel; caps which are so warm as to 
induce perspiration must be avoided, and equally so the 
muslin cap or bonnet which does not give sufficient 
warmth in cold weather. In winter the child's hands 
should be covered with woolen mittens, securely pinned 
to the sleeves of his coat. 

Night Garments. — A baby's night garments, after 
he has passed the stage of infancy, when they are very 
much the same as those worn in the daytime, should 
consist of a shirt, and a woolen union suit with feet. 

Bare Legs. — It is not advisable to allow children of 
any age to go barelegged, except in very hot weather, 
and then, the fewer clothes they wear the better, as 
they will not be so weakened by the heat. 

Short Clothes. — I advise a length of twenty-two 
inches at birth and made with fairly wide shoulders. 



6 HOW TO TAKE CARE OF THE BABY 

They should last through the first year. Long stockings 
must be provided for short clothes. No child should be 
kept in long clothes beyond the first few months, as they 
hamper its movements. 

Clothing of Older Children. — As a child gets older, 
and takes more exercise, his clothing ought to be lighter, 
especially in the house, and his underwear should be 
principally of cotton. Woolen stockings ought never to 
be used, as they cause the feet to perspire and become 
easily chilled. Leather leggings are not to be recom- 
mended for the same reason. Older children should 
gradually discontinue wearing woolen garments next 
to the skin. 

List of Clothing for a Young Baby 

The following list is about the smallest amount of 
clothing that will suffice for a young baby and should be 
in readiness when the child is born : 

Four dozen diapers. 

1 yd. white flannel for binders. 

4 silk and wool, or cotton and wool shirts. 

5 flannel petticoats. 

10 plain slips for night and day use, during the first 
five or six weeks. 

4 pairs knitted or crocheted bootees. 
3 knitted or flannel sacques. 

2 soft shawls. 
1 warm cloak. 
1 hood. 

1 pair mittens. 

After the first six weeks four knitted bands with shoul- 
der straps will be required to replace the flannel bands, 
and six plain little dresses for use in the daytime. 

Complete layettes can be had at various prices at any 
of the large dry-goods stores. 



A MOTHER'S GUIDE 7 

CARE OF THE NAPKINS 

All wet napkins must be removed at once from the 
nursery and put to soak in a pail of water with a cover 
until the time for their daily washing arrives. If they 
are soiled, they should receive a rough washing at once. 
They ought to be thoroughly boiled, washed and ironed 
once a day, and care must be taken that all napkins are 
perfectly dry before using. A napkin should never be 
used a second time until it has been thoroughly washed. 




MANNER OF LIFTING A BABY 



HOW TO LIFT A BABY 

Lifting a New-born Infant. — A new-born infant 
should be handled very little, that is, no more than is 
absolutely necessary in bathing and caring for him, and 



8 HOW TO TAKE CARE OF THE BABY 

when changing his position from time to time while 
lying in the crib. 

In lifting a young baby never grasp him around the 
chest or abdomen. The best way is to catch hold of 
his clothing below the feet with the right hand, and lay 
the palm of the left hand under his back, with the fingers 
extended under his head and neck. In this way the en- 
tire spine and head will be supported. 

Never lift a baby under six months old without sup- 
porting his head. 

Lifting Older Children. — Older children should be 
lifted by grasping the body under the arm-pits, never 
by the wrists or arms. Serious injury is often inflicted 
by lifting a child in this way. 

BATHING 

Bathing the First Few Days. — For the first few 
days after birth an infant should be carefully soaped 
and sponged with water at 100°F. while lying on the 
nurse's lap, and only a small part exposed at a time, in 
order to prevent the baby's catching cold. Care must 
be taken not to uncover or wet the navel. When the 
cord falls off and the navel heals, which usually occurs 
before the tenth day, the full tub bath should be given 
daily, and preferably in the morning, about two hours 
after the first feeding. 

Time for a Bath. — This time is most convenient as 
the baby will then receive his next feeding soon after 
the bath, and will usually go to sleep immediately after. 
After the fourth month there is no objection to giving 
the bath just before bedtime, but never less than an hour 
after a meal ; in that case a little sponging in the morning 
is necessary. 

Directions for Bathing. — The temperature of the 
room in which the bath is to be given should be not less 



A MOTHER'S GUIDE 9 

than 70° F. and it is better to give it in front of an open 
fire, if possible. The temperature of the bath must be 
between 98° and 100°F. for the first six months; after 
that, it can be given at 95° ; a much lower temperature 
than this is not sufficient for cleansing purposes. 

Articles Required. — The following articles are re- 
quired, and should be in readiness before beginning the 
baby's bath, so that it may be given quickly and without 
interruption. 

An oblong rubber or tin bath-tub placed on a low 
table. Bath thermometer. A low rocker without arms 
for mother or nurse. A rubber apron for mother or 
nurse, and a large piece of flannel or flannel apron to 
be worn over it. On a table close at hand should be 
placed the soap, either castile or a very fine toilet soap, 
soft towels for drying, a threaded needle for sewing 
bands, scissors, soft hair brush, absorbent cotton or soft 
lint in small squares, a cup containing a solution of warm 
boric acid (one teaspoonful to a pint), talcum powder, a 
piece of aseptic gauze, and a soft washcloth instead of a 
sponge, as the latter can never be kept clean enough to 
make it safe for a baby's use. In case of chafing, Sal- 
vacea or zinc oxide ointment can be applied instead of the 
dusting-powder. The baby's clothes should be slightly 
warmed, and hung in readiness on a clothes-rack near by. 

How to Give the Bath. — The bath-tub should then 
be filled two-thirds full, and after the temperature is 
regulated, the baby is taken into the mother's or nurse's 
lap and carefully undressed. A table with a raised edge 
can be used instead of the lap. Undressing can be done 
with very little turning or lifting; lay the child flat on 
Jiis stomach while unfastening his garments at the back, 
then turn him once over, roll his garments up and re- 
move them over his head; he can thus be completely 
undressed with very little handling. 

He should be wrapped in the warm flannel apron 



10 HOW TO TAKE CARE OF THE BABY 



While his eyes are washed with a bit of absorbent cot- 
ton dipped in boric acid solution, then his face washed 
in the warm water, and after that the head and ears 
can be soaped with the piece of gauze, washed and 
thoroughly dried. When this is finished, the rest of the 
body is soaped, and he is then carefully lifted into the 
bath. With a young infant, care must be taken to sup- 
port his back and head with the left hand, while the 




LIFTING A BABY IN AND OUT OF A BATH 

right hand grasps the ankles. The baby is placed in 
a semi-reclining position in the tub, and the body 
sponged. Particular care should be taken in soaping 
and washing the genitals with a separate washcloth, as 
scrupulous cleanliness is very essential to the health of 
these parts. The baby should not be kept in the water 
longer than three or four minutes. If a child shows 
any fear of the bath it is a good plan to put a sheet over 
the tub and then gently lower him in it into the water. 



A MOTHER'S GUIDE 11 

Now put the towel on top of the flannel apron, take 
the baby out of the bath, lifting him carefully in the 
same manner as before, and roll him in the bath-towel 
and apron. Dry him thoroughly, but without rubbing, 
then dust him with a little powder, paying particular 
attention to the creases, put on his band, diaper and 
then the clothes. Never put his clothes on over his 
head, but draw them over the feet, catch hold of the 
feet and elevate the body slightly, then pull them all the 
way up ; the sleeves can then be drawn on with greater 
ease. 

Cleansing of Mouth, Nose and Ears. — When the 
baby is dressed the mouth should be carefully cleaned 
with a boric acid solution by means of a swab made 
from absorbent cotton twisted around a toothpick. 

The ears and nose should be examined, and treated 
in the same manner, but with the utmost gentleness, 
and of course, using a clean swab in each case. 

Chafing of Skin. — Chafing is caused: 

a. by not drying the skin properly, 

b. by rubbing it too long or too vigorously, 

c. by using too much soap, or too strong a soap, 

d. by hard water containing much lime, 

e. by too many clothes and constant perspiration. 

To remedy this condition give bran baths for the next 
few days and use plenty of dusting powder, or rub some 
cocoa-butter on the skin. 

Bran Bath. — The daily bath should never be 
omitted, except in the case of severe illness or some 
skin trouble, such as eczema. Soap should not be used 
on children suffering from prickly heat. In its place a 
cupful of bran tied in a muslin or cheesecloth bag should 
be squeezed for a few minutes in the water and stirred 
until it has a milky appearance. With infants that have 
very delicate skins the bran bath can be continually 
used. 



12 HOW TO TAKE CARE OF THE BABY 

Soda or Starch Bath. — If a child has hives or heat- 
rash a soda or starch bath is very soothing. If soda is 
used a tablespoonful of bicarbonate of soda should be 
added to the water; if starch, a half-cupful of pow- 
dered laundry starch. These baths should replace the 
use of soap for a few days when the buttocks are chafed. 

Salt-Bath. — A salt-bath is useful in the case of deli- 
cate children, and is prepared by adding a teacupful of 
common salt or sea salt to each two gallons of water. 

Sponge-Bath. — Sponge-baths are very useful in 
cases of fever, and also give great relief to infants and 
children in very hot weather, and will insure a good 
night's rest to a child who would otherwise be restless 
and uncomfortable. In the case of fever, the addition 
of alcohol, about one part alcohol to three parts warm 
water, to a sponge-bath is often useful in reducing the 
temperature. Do not use cold water, as it causes too 
much shock. Some children object to sponge-baths; in 
that case give the ordinary tub-bath, making it a little 
cooler than usual. 

Mustard Bath. — A mustard bath is sometimes used 
in convulsions and prostration. It is prepared by adding 
a heaping tablespoonful of mustard to five or six gal- 
lons of warm water. But first mix the mustard in a cup 
or bowl with a little water and make it into a smooth 
paste, then add it to the bath, otherwise there is danger 
of particles of mustard adhering to the skin and causing 
burns. The child should not be kept in it longer than 
five minutes, and care must be taken that none of the 
water gets into the eyes. 

Cold Douches. — Cold water should never be used 
for bathing children under three years of age, but be- 
yond that age it is often useful in the form of douches 
applied to the throat and chest, or spine, for the pur- 
poses of strengthening them, and followed by vigorous 
friction. 



A MOTHER'S GUIDE 13 



CARE OF THE EYES 

Eyes of a New-Born Infant. — The eyes of a new- 
born infant need very careful cleansing; carelessness 
in this respect often leads to severe inflammation of the 
eyes, and sometimes blindness. 

For the first two weeks they should be cleansed in 
the following manner. Dissolve one teaspoonful of boric 
acid powder in a pint of warm water. Carefully separate 
the lids, and squeeze a little of the warm solution into 
the eye from a piece of absorbent cotton, and wash the 
eyelids carefully. Use a fresh piece of absorbent cot- 
ton for each eye. 

When the baby is older, if the eyes are in a healthy 
condition, it is sufficient to cleanse them daily with boiled 
water and a piece of old linen kept for that purpose, 
tearing off a fresh piece every day. 

Inflammation of the Eyes. — If the eyes become in- 
flamed, or if the lids stick together, and any discharge 
appear, they should be cleansed every hour with the 
warm boric acid solution, and a little vaseline applied to 
the eyelids at night. A physician should be consulted 
immediately about this condition. 

Precaution. — The sun should never be allowed to 
shine in a baby's eyes, and almost equally harmful is a 
strong reflected light when the sky is overcast. A para- 
sol with a green lining is the best protection against this. 
Veils are undesirable for a baby's use, and may injure 
the eyesight. 

CARE OF THE GENITALS 

The genitals of a baby should be carefully cleansed 
once or twice a day with boric acid solution (two tea- 
spoonfuls to a pint of warm water), by means of a piece 
of clean, absorbent cotton. In the case of boys, the 



14 HOW TO TAKE CARE OF THE BABY 

foreskin should be gently pushed back every other day, 
and the parts underneath carefully washed. If the fore- 
skin can not be pushed back easily, no force should be 
used, but the family physician should be informed at 
once. 

Any inflammation of these parts, or discharge from 
them, should be brought to the notice of the family 
physician without delay. 

AIRING 

Airing of Room. — Fresh air is absolutely necessary 
to the well-being of a baby ; in order that his lungs may 
be strengthened and his blood purified, a generous supply 
of oxygen is as essential to his development as his daily 
food. He must, however, be very gradually accustomed 
to this, and it can best be done at first by airing the room 
thoroughly, at least twice a day, and oftener if possible, 
meanwhile removing the baby to another room, and 
bringing him back only when the room has been re- 
warmed to the proper temperature. 

Age and Seasons for Outing. — If it is summertime, 
or if living in the South, the baby may go out for an 
airing in his baby-carriage when one month old, provided 
the sun is shining and it is not windy or damp, but in 
winter in the North it is often not advisable to take a 
young baby out for two months or more after birth. 

Indoor Airing. — His daily airing, however, can be 
accomplished in the following manner: dress him ex- 
actly as if he were going out, put him in his baby-car- 
riage, then take him in a room where the windows are 
all wide open from the top, close the doors, so that 
there will be no draft, and wheel him about the room 
for a quarter of an hour, gradually lengthening the 
time to an hour or two, morning and afternoon. In this 
way his lungs become gradually accustomed to taking in 



A MOTHER'S GUIDE 15 

the cool air, his color and appetite will improve, and he 
will be far less likely to catch cold than if forced to 
breathe a furnace-heated atmosphere all day long. 

General Rules for Outings. — After a few weeks of 
indoor airing, the child can be taken out in the open 
on a mild, sunny day, but this should not be done under 
the age of four months if the temperature is below 
freezing, nor on days when it is below 20° until he is 
a year old. In fine weather he should be out for four 
or five hours each day. In winter the best hours for 
his airing are from 10 a. m. to 3 p. m., in spring and 
autumn from 9 a. m. to 4 p. m., but in midsummer, on 
hot days, his outings should be taken in the early morn- 
ing, and in the late afternoon; he must, however, never 
be kept out after the dew has begun to fall. In the heat 
of the day he is better off on a cool veranda. 

Sleeping Out-of-Doors. — Sleeping out-of-doors is 
very beneficial to a baby, and he should be trained to 
have his daily nap out in the open whenever this is pos- 
sible, but care must be taken to shield him from strong 
winds, and in summer he should be protected by a mos- 
quito netting. 

Precautions. — The only times when it is not ad- 
visable to send a well baby over four months old out 
are on foggy or very windy days, when it is raining, 
snowing, or the temperature below 20°, or if it is cloudy, 
and much melting snow on the ground. On days like 
these, the indoor airing can always be substituted; it 
will also be found useful after an illness, when it is not 
advisable to take the child out in the open. 

Never allow the light to shine directly into a baby's 
eyes. A parasol lined with green should always be pro- 
vided to prevent this, as serious injury to the eyesight 
may result from neglecting this precaution. 

Never send a baby out with cold hands and feet, and 
be sure he is sufficiently warm; but, on the other hand, 



16 HOW TO TAKE CARE OF THE BABY 

do not overwrap him and cause him to perspire, as this 
is the surest way for him to catch cold. 

Importance of Out-of-Door Air and Exercise. — A 

child over one year old can stand much cooler air, and 
when old enough to exercise he should be allowed to 
run about in almost any weather, properly protected 
from the cold or damp, and provided he is in good health. 
Children kept too closely housed, in overheated and 
badly ventilated rooms, and deprived of, or given insuffi- 
cient outdoor air and exercise,, are bound to suffer as a 
result. They lose their appetite, become pale and anemic, 
sleep badly and catch cold easily. 

EXERCISE 

Exercise in Infancy. — In early infancy the only 
means a baby has of taking exercise is by crying, kick- 
ing, and waving his arms; and he should be allowed to 
indulge in these exercises, in order to expand his lungs 
and develop his muscles. A half hour's lusty crying in 
the day is actually beneficial to an infant, and after the 
first month he should be allowed to kick on the bed for 
a few minutes two or three times a day, with his arms 
and legs quite free. Even from birth he should not be 
left to lie quiet for too long a period of time, but must 
be picked up and carried about occasionally. This is 
especially true of weakly infants or those suffering from 
malnutrition ; their position should be frequently changed, 
and they should be carried about more often than a 
healthy child, and also rubbed two or three times a day 
with cocoa butter. These measures all help to strengthen 
an infant's vitality, and are as necessary to his develop- 
ment as the routine in regard to bathing, sleeping, etc. 

Care in Lifting. — Great care must be taken in regard 
to lifting a young baby, and he must never be placed 



A MOTHER'S GUIDE 17 

in an upright position without proper support, as spinal 
deformities often follow neglect of this precaution. 
When a little older, babies are often forced to stand 
upon the lap, and if they are then suffering from rickets, 
any deformity of the legs, such as bow-legs, or knock- 
knees, may be aggravated. 

Walking. — A child should never be taught to walk ; 
he will do so readily enough when his legs are able to 
support him, and only harm can come from forcing 
him too soon. 

Daily Exercise. — Before he walks he should be put 
on a heavy blanket or quilt in an exercise pen for an 
hour or so twice a day, and allowed to kick and roll 
about to his heart's content. When he has once learned 
to walk, there will be no difficulty in his getting sufficient 
exercise if he is strong and healthy, and allowed enough 
freedom to do so. All romping and violent exercise 
should be confined to the earlier part of the day, as it 
may prove harmful if indulged in just before bedtime. 

Older Children. — As children grow older, they 
should play more out-of-doors, and all forms of exer- 
cise should be encouraged, provided they are never so 
violent or prolonged as to lead to exhaustion. 

Indoor Exercise. — Indoor exercise for older children 
should be confined as much as possible to very rainy 
weather, and the temperature of the room regulated to 
be not above 65° F. Their clothing should be loose 
and light. 

SLEEP 

Sleep a Guide to Health. — Sleep in infancy is a very 
accurate guide to the child's physical condition. It should 
be quiet and regular, and any signs of prolonged rest- 
lessness may be taken as a symptom of some disorder, 
usually digestive. 



18 HOW TO TAKE CARE OF THE BABY 

Amount of Sleep During Infancy. — A baby's sleep 
during the first few days of life should be almost con- 
tinuous, his only waking intervals being for nursing and 
bathing. For the first month he should sleep twenty- 
two hours out of the twenty-four ; after this, his periods 
of waking will be gradually lengthened until at six 
months his day's sleep will be arranged as follows: A 
two hours' nap in the morning, and another about the 
same length of time in the afternoon. At 6 p. m. he 
should be put to sleep for the night, except that at ten 
o'clock his diaper should be changed, and his night feed- 
ing given, but without disturbing him in the crib. If he 
is quite well, and has not developed any bad habits, he 
will fall asleep immediately after this, and should not 
wake until six the next morning. 

Sleep After Two Years. — At about two years of age 
a child should learn to sleep from 6 p. m. to 6 a. m. 
without feeding. This twelve hours' rest at night should 
be continued up to six years of age. 

Day-Naps. — From the eighteenth month, one of the 
day-naps may be discontinued, but the child should be 
encouraged to take one nap a day for as long a time as 
he will, up to four years of age, or longer. 

Position of Child During Sleep. — It is important to 
turn a young infant from time, to time, for if he is al- 
lowed to sleep too much on one side, it is liable to cause 
deformity of the head. He should never be placed on 
his back to sleep, and even when awake, only when the 
mother or nurse is constantly present, for if an attack 
of vomiting were to occur he would be very likely to 
get food into his windpipe. 

Directions for Children's Sleep. — A baby must sleep 
alone from the first; lying with the mother is very apt 
to lead to irregularities in nursing, etc., and there is 
also the danger of overlying. Older children should 
have separate beds, thereby minimizing the chances of 



A MOTHER'S GUIDE 19 

any infection, and also insuring a good night's sleep for 
one child in the event of the other one being restless or ill. 

How to Prepare a Baby for Sleep. — The baby should 
be undressed and prepared for bed, and the diaper 
changed before giving the bottle ; he should be laid down 
immediately after feeding while he is still awake, the 
room darkened and the window opened. He must learn 
to go to sleep by himself, and all habits such as rocking 
or patting, or the giving of a pacifier or finger to suck, 
ought never to be allowed, as they will only lead to 
more trouble in the end. If he is restless and refuses 
to sleep there is some good reason for it, and this must 
be found and remedied, as nothing else will produce any 
lasting results, but will only lead to bad habits in addi- 
tion. Soothing sirups and drugs must never be admin- 
istered under any circumstances by a mother or nurse; 
if a drug is given, it must be on the advice of a physi- 
cian. 

How to Treat a Crying Baby. — A baby may cry for 
a few minutes before going to sleep ; this is exercise for 
his lungs, and unless it is prolonged no notice should be 
taken of it. It is also a mistake to pick up a baby im- 
mediately if he wakes and cries at night, for if left alone, 
he will often go to sleep again. If he does not, and be- 
fore taking him out of bed, try turning him over. This 
may accomplish the desired result. 

Quiet. — While the baby's room should not be noisy, 
it will never be necessary to whisper or make any un- 
usual efforts at quietness; if he has been accustomed 
from the first to the ordinary household sounds, he will 
not notice any noises, unless they are very sudden, shrill, 
or unusual. 

Sleeplessness and Its Common Causes. — If, how- 
ever, a baby awakes often and is restless, or stays awake 
a long time, it will probably be due to one or another of 
the following causes : 



20 HOW TO TAKE CARE OF THE BABY 

1. In a nursing baby, frequently hunger. 

2. Thirst. 

3. Cold feet or wet diaper. 

4. Insufficient or too much clothing. 

5. Derangement of digestion, due to improper food, 
or irregular feeding, over-feeding, or too much night 
feeding. 

6. Bad or irregular habits. 

7. Bad air and insufficient ventilation. 

8. Dentition. 

9. Excitement or nervous fears, sometimes induced 
by romping and playing with a child just before bed- 
time. 

Other Reasons. — These are the most common causes 
of insomnia in infancy, but other reasons may also exist, 
such as anemia or malnutrition; imperfect breathing 
due to adenoids or tonsils, or the earliest symptoms of 
hip-disease or some other illness. In dealing with any 
of these conditions, it is imperative to consult a physi- 
cian. 

Treatment. — Having investigated and corrected 
any mistakes in feeding or habits of a baby suffering 
from sleeplessness, whatever the cause may have been, 
the following routine should be observed: A simple 
diet at regular intervals, no eating or drinking at night 
except water, no excitement, plenty of fresh air in the 
daytime^ and at night a quiet, dark and airy room. A 
warm bath before going to bed will often be found bene- 
ficial, and in the case of older children, the reduction 
of foods that induce flatulence, such as sugar, starch, etc. 

A Nervous Child. — A delicate, nervous child is often 
a bad sleeper, and in this case the same rules are to be 
followed, particular attention being paid to keeping him 
from any excitement; if the child is older, no study 
should be allowed for a time, but instead, plenty of ex- 



A MOTHER'S GUIDE 21 

ercise in the fresh air. If this routine is rigidly fol- 
lowed, there is no reason why the condition should not 
be overcome even if the nervousness is hereditary. 

Habit of Sleep. — Children do not sleep to excess 
unless some drug has been administered, or unless they 
are sick. In health, sleep is largely a matter of habit, 
and it sometimes happens that a baby develops the bad 
habit of sleeping longer in the daytime, and staying 
awake at night. If this is not due to any other condi- 
tion, it is easily remedied by forcing him to remain 
awake longer in the day, he will then become tired, and 
is more likely to sleep at night. 

Sleep of Early Infancy. — Although a young infant's 
sleep should be quiet, it is not very deep, and it is not 
until about three years of age that a child sleeps heavily. 

NURSING 

It is undoubtedly the duty of every mother to nurse 
her baby, and regard for his welfare should induce her 
to attempt it even if the chances of success seem small, 
except in the following conditions rendering it an im- 
possibility, such as : 

Conditions Making Nursing Impossible. — A defect 
in the nipples or the absence of milk. An infant unable 
to suck properly, owing to his being very weak, or tongue- 
tied, or having a cleft palate. (In the last case, the milk 
comes out through nostrils.) 

Conditions Prohibiting Nursing. — In addition to 
these, are certain conditions of the mother when nursing 
should be absolutely forbidden. These are as follows: 

1. When the mother is suffering from tuberculosis 
in any form. 

2. When she has a serious disease of the heart or kid- 
neys. 



22 HOW TO TAKE CARE OF THE BABY 

3. When she is suffering from any infectious or con- 
tagious disease, such as diphtheria, pneumonia, whoop- 
ing cough, etc. 

4. When she is epileptic or choreic. 

5. When she is losing flesh and strength, and is much 
debilitated. 

When a mother has recovered from a short illness, 
during which she has not nursed her baby, and finds 
that she has still some milk in her breasts, she should 
resume nursing. Sometimes the milk returns as abun- 
dantly as before the sickness. 

Successful Nursing. — A great deal will depend upon 
the care of the breasts and nipples, and the regulation 
of the mother's diet and habits. The following simple 
rules must be adhered to if success is to follow: 

Care of the Nipples and Breasts. — A day before the 
arrival of the infant the nipples should be carefully 
washed with soap and water and a soft brush used to 
keep the openings in the nipples clear. Before and after 
nursing, the nipples must be washed with a solution of 
boric acid and carefully dried. 

It is very important to prevent sore nipples, and if 
they are at all tender after nursing^ the washing with 
boric acid should be followed by sponging with alcohol, 
and then drying. Applications of zinc oxide ointment or 
boric acid ointment are very healing. A nipple shield 
may be used, but most infants refuse to nurse from them. 
The breast must be squeezed so as to fill the nipple be- 
fore putting the baby to it. 

If the nipples are very sore and bleeding, it is some- 
times necessary to keep the baby from nursing for a 
day or two. The breasts ought then to be massaged 
with sweet oil, first washing hands and breasts with 
soap and water. The breasts should be massaged all 
the way around with firm pressure, starting from the 



A MOTHER'S GUIDE 23 

base, and ending up at the nipple. Afterward a breast 
pump must be used to draw off the milk. 

When they are healed, the baby should be put to the 
breast only every other nursing for a day or so. If the 
milk is abundant, pump and keep it in a bottle, using it 
for the intermediate feedings. 

Large pendulous breasts should be supported at first 
by bandages, and later by loose corsets. If the milk 
seems slow in coming or is scanty, the breasts may be 
massaged for five or ten minutes two or three times a 
day to increase the flow. 

Rules for a Nursing Mother's Guidance. — 1. A 
nursing mother should lead a simple, regular life, on a 
diet to which she has been accustomed, but avoiding too 
much meat, strong coffee, pastry, candy, spices, or highly 
seasoned dishes. Plain, well-cooked food should be given 
her, with plenty of milk and no alcoholic beverages, ex- 
cept when prescribed by a physician. She needs the 
mineral salts of vegetables; she should therefore have 
the purees of a mixture of vegetables. None of the 
water in which these vegetables are cooked should be 
thrown away. Only whole wheat bread should be eaten. 

2. She needs plenty of sleep, at least eight hours, and 
if she has had a bad night, she should take a nap in the 
daytime. 

3. She must have regular exercise, at least one hour's 
walk morning and evening, but she ought never to tire 
herself to the point of exhaustion. 

4. She must avoid late hours, worry and excitement, 
as the effect of these is most detrimental to the milk. 

5. She should keep her bowels regular by means of 
proper diet and exercise, and, if necessary, by a mild 
cathartic, such as Cascara, Citrate of Magnesia, Ro- 
chelle Salts, Glauber's Salts, etc., but this should not be 
continued indefinitely. Two or more bran biscuits (see 



24 HOW TO TAKE CARE OF THE BABY 

food recipes) a day included in her diet will help in 
keeping her bowels regular. If the constipation becomes 
chronic, however, she should consult a physician. 

6. A nursing mother often becomes anemic, with 
the result that her milk is deficient in iron, thereby caus- 
ing the child to become anemic also. It is a good plan, 
therefore, when in this condition, to apply to her physi- 
cian for an iron tonic. 

7. With the above exceptions she should take no 
drugs or medicines unless they are ordered by the physi- 
cian. 

Schedule for Nursing. — The infant should be put 
to the breast five or six hours after birth, and then every 
four hours for the next two days; after that according 
to the following schedule : 



1st & 2nd day 
Every 
4 hours 


1st & 2nd months 

Every 

V/?. hours 


3rd, 4th & 5th months 
Every 
3 hours 


After 

5 months 
Every 3 hrs. 


4 a. m. 


6 a. m. 


6 a. m. 


6 a. m. 


8 a. m. 


8 :30 a. m. 


9 a. m. 


9 a. m. 


12 p. m. 


11 a.m. 


12 a. m. 


12 p. m. 


4 p. m. 


1 :30 p. m. 


3 p. m. 


3 p. m. 


8 p.m. 


4 p. m. 


6 p. m. 


6 p. m. 




6 :30 p. m. 


10 p.m. 


10 p.m. 




10 p. m. 


2 a. m. 






2 a. m. 







As mother's milk takes nearly two hours to be com- 
pletely digested, and as a baby usually nurses about fif- 
teen or twenty minutes, the intervals between nursings 
should not be less than two and a half hours. I have 
found by experience that the feeding at 10 p. m. instead 
of 9 p. m. is much more satisfactory, and the child is 
more likely to sleep longer and better. 

The milk in the breast does not secrete in sufficient 



A MOTHER'S GUIDE 25 

amount until the third or fourth day, and sometimes 
later. 

Regular Nursing Habits. — Regular habits in nurs- 
ing should begin from the first, and strict attention to 
this matter is most important. The baby must never be 
allowed to nurse longer than twenty minutes, and should 
be given one breast at one feeding and the other breast 
at the next, unless he is older and requires more, when 
he may be allowed to nurse ten minutes at each breast 
for every feeding. 

The First Day. — The baby requires no other food 
on the first day, except a little warm water with milk- 
sugar, one-half ounce sugar to ten ounces water ; of this 
he may have from four to eight teaspoonfuls, between 
nursings. Do not give the baby any castor oil or any in- 
jection to make the bowels move. It is quite unnecessary 
and may be harmful. Some nurses give injections with the 
object of getting rid of the meconium or black tarry mat- 
ter in the bowels. Nature never intended babies to be in- 
terfered with in the first few days of their lives. The 
meconium is a natural lubricant for the bowels and 
should not be forcibly removed. 

Training the Baby. — He should be awakened in the 
daytime to nurse, but allowed to sleep after 10 p. m. In 
this way an infant will soon be trained to sleep all night, 
and at the age of five months a healthy baby will re- 
quire no nursing between 10 p. m. and 6 a. m. This 
can be easily accomplished by never deviating from the 
regular feeding schedule, and will be of great benefit 
to both mother and child. Infants can often be trained 
at an earlier age to sleep all night without nursing. 

Mixed Feeding. — It is advisable to begin giving a 
baby one bottle in the twenty-four hours from the time 
he is one or two weeks old, beginning with formula No. 
2 and gradually increasing the amount so as to be suit- 
able for his age. The reasons for this are various. The 



26 HOW TO TAKE CARE OF THE BABY 

mother may be suddenly taken ill, or unavoidably ab- 
sent, or her milk may be temporarily unfit for the baby's 
use, as a result of violent emotion, menstruation, etc. 
As a precaution, therefore, against any of these even- 
tualities, it is wise to accustom the baby at an early age 
to taking the bottle, for it is much more difficult to get 
him to do so when he is older. It also makes it much 
easier later to wean him. 

When Milk Does Not Agree. — It may sometimes 
happen that the mother's milk does not agree with an 
infant, but she should not for that reason give up nurs- 
ing until every effort has been made to discover the 
cause, and, if possible, to rectify it. If the infant shows 
symptoms of indigestion, viz., vomiting, colic, diarrhea, 
or constipation, it is necessary to find out to which of 
the following conditions this is due: 

1. The child takes too much at each nursing. 

2. The child takes the milk too quickly. 

3. The milk is too rich. 

4. The milk is scanty. 

5. The milk is too poor. 

More than one of these conditions may exist at the 
same time. 

The First Two Conditions. — The first two condi- 
tions may be ascertained by carefully weighing the baby 
before and after nursing. The child need not be un- 
dressed for this purpose, and the scales must be ac- 
curate. Now suppose an infant one month old, that is 
not thriving and weighs only six pounds and eight ounces, 
weighs four or five ounces more after nursing for 
twenty minutes, we then know that it has taken too 
much and that being under weight it should not have had 
more than two and a half ounces or three ounces. At 
the next hour for nursing, we weigh the baby, allow 
it to nurse two minutes at one breast, and then weigh 
it again. After that we give it the other breast, weigh 



A MOTHER'S GUIDE 27 

it once more, and in this way we ascertain not only- 
how much the child has taken, but how quickly. If 
the amount is too large we shorten the time of nurs- 
ing at each breast to five, six or seven minutes, de- 
pending upon the amount taken, or give it only one 
breast at a nursing, and weigh the child before and 
after feeding until we have regulated it to the requisite 
amount. Some infants can take at the rate of as much 
as one ounce of milk a minute during the first few 
minutes, and thus not only overload their little stomachs 
but also nurse too quickly. 

Signs of Too Much Milk. — Symptoms in a nursing 
baby taking too much milk: 

a. Shows rapid gain in weight. 

b. Seems overfed after nursing. 

c. Vomits after meals. 

d. Has wind and colic. 

e. Perspires on head and neck. 

f. Is drowsy and heavy, and sleeps a great deal, but 
may be restless from colic and wind. 

g. Passes much urine, diapers are always wet. 
h. Has frequent large stools. 

One or more of these symptoms may be present. 

Too Quick Nursing. — If the trouble is due to too 
quick nursing, the child can be put to the breast for two 
minutes at a time with intervals of one or two minutes, 
or the mother can compress the base of the nipple be- 
tween the first and second fingers while the child is nurs- 
ing. The latter method will be found easier for both 
mother and child. If this does not succeed, nurse less 
and give one or two ounces of water before nursing. 

Too Rich Milk. — In the condition under heading 
No. 3 above, the infant will often show symptoms, such 
as vomiting, colic, green stools, diarrhea or constipa- 
tion, restlessness, sleeplessness, etc. 

The milk is made too rich by : 



28 HOW TO TAKE CARE OF THE BABY 

1. Too rich foods. 

2. Too little or too much exercise, fatigue or want of 
sleep. 

3. Mental excitement, social engagements, etc. 

4. Emotional disturbances, grief, temper, etc. 

5. The onset of menstruation. 

Having previously ascertained that the child is not 
taking too much, nor feeding too rapidly, we can be 
reasonably certain that the milk is too rich. We there- 
fore proceed as follows : 

Treatment. — The infant should be given, before each 
nursing, an ounce of warm water which has been previ- 
ously boiled, and, if necessary, slightly sweetened with 
one-fourth teaspoonful of milk sugar. This can be given 
from a regular feeding bottle and gradually discontinued 
as the child improves. Lengthening the intervals be- 
tween the feedings to at least three hours also tends to 
make the milk poorer in quality. The first few ounces 
taken from the breast are not so rich as the last ones, 
therefore the child should not be allowed to drain the 
breasts, and must not nurse so long as he has been ac- 
customed to doing, but should nurse from both breasts. 
The ounce of warm water which he receives before 
nursing dilutes the milk, and at the same time brings 
the quantity up to the requisite amount. 

Rich milk is very often the result of the mother's 
mode of living, and neglect of the rules for diet, exer- 
cise, etc., which have already been enumerated. An 
improvement in the milk will often follow strict atten- 
tion to these matters, particularly by reducing the amount 
of meat, and prohibiting alcohol in any form; also re- 
quiring the mother to take daily exercise in the open 
air. It sometimes happens that the mother's first men- 
struation period, and perhaps subsequent ones, will be 
responsible for indigestion in the infant ; when this hap- 



A MOTHER'S GUIDE 29 

pens, it is usually better to give the bottle at alternate 
feedings during the time of menstruation. 
i If the child's symptoms do not improve after diluting 
the breast-milk by giving water before nursing, length- 
ening the intervals between nursings to three hours, 
shortening the time of nursing, and careful regulation 
of the mother's diet, and the child is steadily losing 
weight, it will then be necessary to put him on the bot- 
tle, pumping the breasts meanwhile. When he shows 
signs of improvement, two or three days after, he can 
be gradually brought back again to the breast. If this 
is followed a second time by an attack of indigestion, 
he should be weaned, and it is imperative to do this be- 
fore the child's digestion becomes too much weakened. 
Scanty Milk. — Symptoms in a nursing baby which 
does not get enough milk: 

1. It is not satisfied after nursing, and is hungry long 
before the next nursing. 

2. Does not vomit nor suffer from colic. 

3. Is fretful and impatient while nursing. 

4. Little gain in weight. 

5. Does not sleep enough and is restless. 

6. Passes little urine, and the diaper may be stained 
yellow or brick red. This does not occur if the child is 
given water to drink several times a day between nurs- 
ings. 

7. Is very constipated. 

It is easy to determine when the milk is scanty by 
weighing the child before and after nursing. When 
this is the case, the mother should be given an abundant 
diet, with plenty of meat and milk. 

A mother who has not enough milk should not on 
that account be overfed. A mother with her first child 
often does not secrete much milk in the first few weeks. 
She should be encouraged and given hope and confi- 



30 HOW TO TAKE CARE OF THE BABY 

dence that plenty of milk will soon appear. In the 
meantime, the infant should be bottle fed, after being 
regularly put to each breast for a few minutes. A bowl 
of corn meal mush (see recipes) taken at night will 
greatly help to increase the supply of milk. Malt tonics 
are also to be recommended. 

The breasts must be gently massaged two or three 
times daily to stimulate secretion, and every means taken 
to improve the mother's general condition. In this case, 
the chances of success depend entirely on the improve- 
ment of the mother. 

In order that the baby may not lose weight in the 
meantime, he should be weighed before and after the 
nursing in order to ascertain how much short of the 
correct amount he is getting, and a bottle containing as 
many ounces of modified milk as are lacking in the 
supply of breast-milk must be given him. For instance, 
if a normal child of four months, weighing about thirteen 
and a half pounds gets only two ounces from the breast 
where he should receive five ounces, we then give three 
ounces of modified milk, which must be suited to his age 
and digestive capacity. If he has already been accustomed 
to receiving one bottle a day, he will be given his supple- 
mentary feedings of the same formula. If not, he must 
have a very much weaker formula, as No. 5 or 6, instead 
of No. 9, the usual formula at that age. 

Poor But Abundant Milk. — When the milk is poor 
in quality, but abundant in amount, this is shown by the 
child's not gaining in weight, although the weighing be- 
fore and after feeding shows he has had a sufficient 
quantity. He will be restless, probably constipated, but 
will not vomit nor show any intestinal symptoms. This 
is the condition with the least favorable outlook for the 
continuance of nursing. The mother's diet must be made 
more nourishing, with plenty of milk, cereals, meat, 



A MOTHER'S GUIDE 31 

poultry, fish, etc., but if conditions do not improve, the 
child may have to be weaned. 

Nursing mothers should not hastily conclude that their 
milk does not agree, for faulty conditions are very often 
remedied, and the nursing continued satisfactorily, and 
to the great benefit of the child. On the other hand, 
when an infant continues with bad symptoms in spite of 
all care, he should be put on artificial food alone for a 
few days, and if this agrees with him, and with the ap- 
proval of a physician, weaned at once. In this case, it 
would be a great mistake to carry on a mixed feeding: 
viz., half breast fed and half bottle fed, for we have 
already proved that the breast-milk does not agree, and 
a continuance of it can only lead to further disturbance. 

Mixed Feeding. — It is sometimes advisable to carry 
on mixed feeding, i. e., alternate nursings and feedings, 
from the beginning, in cases where the mother's milk 
is insufficient, but does not disagree. It would be wrong 
to deprive the child entirely of the breast-milk, although 
it is obviously 'necessary to supplement it with the bottle. 

Formula for Bottle in Mixed Feeding. — When one 
bottle in twenty-four hours is given at the age of two 
weeks for the purpose of accustoming the child to the 
bottle, Formula No. 2 (see page 54) should be used, but 
as it is not necessary to make so large an amount, a ten- 
ounce mixture, composed of half the amounts mentioned, 
will be sufficient. It is not desirable to make up less 
than this, as the quantities can not be so accurately 
measured. Of this, two and a half to three and a half 
ounces should be given once a day. If necessary to give 
more than one bottle, owing to the mother's illness, ab- 
sence or any other reason, the same formula must be 
used; but in any case, if the child makes a satisfac- 
tory progress, after a few days the formula should 
be changed to the next stronger one, thus very grad- 



32 HOW TO TAKE CARE OF THE BABY 

ually increasing first the quantity and then the quality 
of the daily bottle until at six months the child takes 
six ounces of Formula No. 11. At this age he should 
be given two bottles a day, morning and evening, 
these being carefully regulated according to the child's 
age, weight and condition. The food must be increased 
until at nine months of age he gets two bottles of 
Formula No. 13 or 13j^, about eight ounces to each 
feeding, alternating with three nursings, at four-hour 
intervals. At about the tenth or eleventh month weaning 
should begin, and breast-feeding ought never to be con- 
tinued after the twelfth month, unless specially ordered 
by a physician. 

WET-NURSING 

Difficulties. — There are so many difficulties in the 
way of obtaining a good wet-nurse, and her advent in 
a household is generally followed by such disagreeable 
consequences that she is usually only resorted to in very 
extreme cases, i. e., when a baby's life is in danger, and 
all other methods of feeding have failed. It must be 
remembered that a baby who has not nursed more than 
a few days will rarely take the breast when more than 
three months old. But it is well worth trying. 

Cases Where Service of Wet-Nurse Is Indicated. — 
Too much time should not be lost, however, before pro- 
curing a wet-nurse, if the case is urgent, lest even her 
services may fail to be of any use. It is advisable to 
secure one in the case of a premature baby under five 
pounds, when the mother is unable to nurse him, or for 
any baby under six months of age who is suffering from 
chronic indigestion, inanition, and continuous loss of 
weight. For these, wet-nursing is often the only means 
of salvation, and is frequently followed by rapid gain 
in weight, when every other method of feeding has been 
attended by steady loss. 



A MOTHER'S GUIDE 33 

Selection of a Wet-Nurse. — In selecting a wet-nurse, 
the importance of a thorough physical examination of 
both the mother and her child by a physician is of the 
greatest importance. She must be in good health and 
free from tuberculosis, syphilis, or any skin disease, and 
her teeth and hair must be carefully inspected. The 
size of her breasts are by no means an infallible guide, 
for large breasts do not always mean an abundant supply 
of milk, and sometimes smaller breasts will have more 
milk. The only way of correctly estimating a woman's 
supply of milk, is by weighing her own baby before and 
after nursing. 

If possible, a woman between the ages of twenty and 
thirty should be chosen, and one with her first baby. 
It is not necessary for her own infant to be the same 
age as the foster child, as the changes in the milk after 
the first month are very slight. It is not safe to take a 
woman whose baby is under two or three months old, 
for if the mother has any syphilitic taint, it will often 
never be visible in herself, but her child will develop it 
during the first two or three months of its existence; 
therefore, until that age is passed, we can not be sure 
of the mother's fitness in that respect. It is the condi- 
tion of her own baby that is a woman's best recommenda- 
tion for the position, and it is never safe to engage one 
whose baby has died, unless on the special recommenda- 
tion of a physician who has had both mother and child 
under his care. 

Even when all things seem favorable, it is always an 
experiment, for what suits one baby may not suit an- 
other. 

Dilution of Milk. — For a premature baby or one 
under one month old, provided it can take the breast 
properly, the breast milk should be diluted at first by 
giving the child from two to four teaspoonfuls of water 
before nursing. 



34 HOW TO TAKE CARE OF THE BABY 

If the baby is unable to suckle properly, the milk must 
be pumped, and then diluted with an equal amount of 
water before offering it to the child. While the milk 
is being pumped, the woman should be allowed to nurse 
her own baby, otherwise the milk is liable to dry up. 

Cases Where Pumping the Milk Is Necessary. — 
Sometimes a baby who has been accustomed to the bot- 
tle will refuse to nurse, and in this case also pumping 
has to be resorted to, and the milk given from the bottle. 
If this is kept up for two or three weeks only, with a 
baby suffering from acute inanition, it may be sufficient 
to start him on the right road. 

When a wet-nurse is not obtainable, some reputable 
nursing-woman in the neighborhood may be induced 
to pump some of her milk once or twice a day. This 
milk given at two feedings for a short time will often 
be the means of bringing about a favorable turn in the 
child's condition. 

Pump Recommended. — The English breast-pump 
is generally used. A simpler and more effective pump 
can be improvised as follows: select a baby's bottle, or 
any other bottle, the mouth of which fits easily over the 
motker's nipple. Place the bottle in boiling water for a 
minute, then remove it and dry it rapidly by holding it 
in a towel and shaking out all the water. With a cold 
wet cloth cool off the mouth of the bottle, then place it 
firmly over the nipple. As soon as the bottle begins to 
cool, the milk will flow into it. 

Treatment of a Wet-Nurse. — The failure of wet- 
nurses is often due to their being overfed, and given a 
variety of rich, highly seasoned dishes to which they are 
not accustomed, and also deprived of their usual exer- 
cise. This causes an attack of indigestion, w T ith very 
bad effects on the milk. 

A wet-nurse should be given plain, wholesome food, 
and besides nourishing the infant, should be allowed to 






A MOTHER'S GUIDE 35 

help in caring for it, and also to take it for its daily- 
airing. She must have sufficient air and outdoor exer- 
cise to insure her keeping in good health, and the state 
of her bowels should receive careful attention. 

Wet-Nurse's Own Infant. — She must be watched 
both indoors and out to prevent any indiscretions likely 
to be detrimental to the health of her charge; but it is 
strongly recommended that, where possible, she be al- 
lowed to keep her own infant with her. By allowing 
this privilege, you are likely to secure a better class of 
woman than otherwise, and do not run the risk of her 
milk changing as a result of her worrying over her own 
baby. This is often the reason why a wet-nurse's milk 
fails to agree, and only adds to the troubles of the sick 
infant. 

While it may be necessary to feed a wet-nurse's own 
child by bottle, it is good policy to allow him two or 
three breast feedings a day, both for the desirable mental 
effect on the mother, and also because, his sucking being 
stronger than the sick baby's, it will encourage the flow 
of milk. Nursing her own baby must, however, be done 
at the regular nursing hour instead of the foster child's 
nursing, or if the milk is abundant, immediately after. 
The two- or three-hour intervals between nursings must 
not be interrupted by the nurse suckling her own child, 
otherwise it will change the character of her milk. 

A wet-nurse whose milk is abundant, will be able to 
nourish her employer's baby as well as her own, to the 
great benefit of both. It has been conclusively shown 
that a good wet-nurse can bring up her own baby and 
one or two other infants on her breasts. At Bellevue 
Hospital two wet-nurses gave five quarts of milk a day 
between them and nursed fourteen babies three times a 
day. A wet-nurse at the Babies' Hospital usually nurses 
three or four babies several times a day. 

Introduction of a Bottle. — As soon as a sick baby 



36 HOW TO TAKE CARE OF THE BABY 

has started to gain on a wet-nurse's milk, it is advisable 
to begin giving him one or two bottles of modified milk 
a day, so that he may be gradually accustomed to it and 
the wet-nurse dispensed with as soon as possible. It is 
also a wise plan to adopt as a precaution in case of the 
wet-nurse's illness or sudden departure. 

WEANING 

Reasons for Early Weaning. — Under normal condi- 
tions, when the child is thriving, and the mother is in 
good health, weaning should never begin before the age 
of nine or ten months, but conditions often arise which 
make early weaning imperative. These are: 

1. Severe illness of the mother, such as typhoid fever, 
pneumonia, etc. 

2. Chronic illness or weakness of the mother. 

3. Pregnancy. 

4. Stationary weight of a child for two weeks, or 
steady loss of weight for one week, for no assignable 
reason, even after the mother's diet and hygiene have 
been attended to. 

5. When the milk disagrees in spite of all measures, 
and the child suffers from colic, green stools, vomiting, 
restlessness and sleeplessness. 

It sometimes happens that an infant will not thrive 
on the mother's milk, although no apparent cause can 
be found, the milk being up to the standard both in qual- 
ity and quantity. In this case, the child's symptoms 
must be the only guide, and weaning should be resorted 
to without delay. 

Mixed Feeding. — Often when a child loses weight 
or fails to gain, it is advisable to begin supplementary 
feedings at once, but he need not be taken off the breast 
altogether, and mixed feeding can be continued for some 



A MOTHER'S GUIDE 37 

time before weaning is accomplished. In the first three 
conditions mentioned as reasons for weaning, it must of 
course be done at once, and the child put on a very weak 
formula of modified milk. 

Avoid Weaning in Summer. — Except for any of the 
foregoing reasons, weaning should not be attempted in 
summer, but if the mother's milk is becoming scanty, 
mixed feeding may be begun. At this season the greatest 
care should be taken in introducing cow's milk, the 
formula must be much weaker than the one usually 
given for the child's age, and if there is any epidemic 
of summer diarrhea, or typhoid or contagious diseases, 
the milk should be pasteurized. 

Too Sudden Weaning Apt to Cause Indigestion. — 
As a general rule, and under normal conditions, nursing 
should not be continued in any case after the twelfth 
month, but in the majority of cases, weaning should 
take place at about the tenth month, as the milk usually 
becomes scanty and poor in quality by that time. Too 
sudden weaning is liable to cause indigestion, therefore, 
it should be done gradually in the following manner. At 
the ninth month one bottle can be substituted for a nurs- 
ing, or if the child is accustomed to one bottle in the day, 
a second bottle can be introduced. After an interval of 
three or four days another may be given, and so on, until 
after about a month's time the child will be entirely 
weaned. 

Drinking From Bottle. — If the child has been trained 
to drink water from the bottle, or has been given one 
bottle a day from an early age, as has been advised in 
another chapter, there will be no difficulty in getting him 
to take his food from the bottle, but otherwise, it may 
require a little coaxing before he will be induced to take 
it. Sometimes actual starvation for a short time may 
have to be resorted to, as only hunger will force a baby 



38 HOW TO TAKE CARE OF THE BABY 

to drink from the bottle. In this case the breast should 
be sternly withheld until his opposition to the bottle has 
been overcome. 

Weaning at Twelve Months of Age. — If a baby is 
thriving, and gaining steadily in weight, and the mother 
is in good health, and particularly if summer intervenes, 
it is wise to postpone weaning until the baby is twelve 
months old. At this age, it is simpler to begin teaching 
the baby to drink from a cup, as this will obviate the ne- 
cessity of weaning him from the bottle later on. 

Teaching to Drink From a Cup. — He can be taught 
by feeding him a small amount at a time from a tiny 
cup, or by giving him a little from a spoon. Some 
babies will take milk more readily from a cup or spoon 
than from a bottle. In any case, by the age of fourteen 
months the use of the bottle should be discontinued, ex- 
cept for the last feeding at night, which may be given 
from the bottle, as the child would be too much roused 
by feeding from a cup at that hour. 

If a child has been allowed to drink steadily from a 
bottle until the second or third year, it will be found 
very much harder to break him of the habit, the con- 
tinuation of which may interfere with his nutrition, as 
he will often be unwilling to take any solid food from 
a spoon. In obstinate cases, it is often necessary to let 
him remain hungry until he is willing to drink from a 
cup. 

Loss of Weight Likely at First. — For the first week 
or two after weaning a child is apt to lose weight until 
he becomes accustomed to cow's milk, after which he 
will gain steadily and often more rapidly than before. 

Care in Selection of Formula. — Signs of indigestion 
during the first few days of weaning are usually due 
to too strong a mixture of cow's milk, and a child who 
has just been weaned should never be given a formula 
of the same strength as would be given to a bottle-fed 



A MOTHER'S GUIDE 39 

child of the same age. For instance, if a child is weaned 
at nine months, instead of giving him Formula No. 13^ 
the usual one at that age, he must begin with No. 8 or No. 
9, and gradually increase it until he is taking the right 
formula for his age and weight. But, being older, he 
can take a large quantity of the weaker formula, viz., 
about eight ounces. 

Care of Breasts. — When it is time to wean the in- 
fant or when only two nursings are given per day, the 
times for nursing should be gradually set farther and 
farther apart, and the baby nursed only when the breasts 
are distended and painful. In about eight or ten days' 
time the breasts will be dry. 

Sudden Weaning. — If weaning has to be done sud- 
denly (owing to the illness of the mother, etc.) the 
breasts should be tightly compressed by a bandage around 
the chest. In addition to this, the mother should abstain 
almost entirely from fluids, and take enough of some 
saline laxative such as Epsom Salts, Rochelle Salts, 
Citrate of Magnesia, etc., to produce three or four 
watery stools a day. If in bed, she should have in ad- 
dition an icebag on the breasts. 

Drying up of the breasts can be accomplished in a 
more agreeable manner by the administration of potas- 
sium citrate, twenty to thirty grains, dissolved in water, 
three or four times a day, thereby producing a copious 
flow of urine. 

ARTIFICIAL FEEDING 

A Substitute for Mother's Milk. — When mother's 
milk is not obtainable, a substitute must be found in the 
fresh milk from some animal. Cow's milk has been 
found the most satisfactory, and is the one in general 
use, but with various modifications. Fresh milk in some 
form or other is absolutely necessary. Other foods, 



40 HOW TO TAKE CARE OF THE BABY 

alone, may appear to answer the purpose for a short 
time, but there is danger in their continuance, for scurvy, 
rickets, or malnutrition will be sure to follow their pro- 
longed use. 

Composition of Cow's Milk. — As cow's milk is very 
different in composition from mother's milk, our object 
must be to modify it, or, in other words, to make it 
more nearly resemble mother's milk, and furthermore, 
to adapt it to the child's age and digestive capacity. This 
can be successfully accomplished in the majority of cases, 
but we must first realize the essential points of differ- 
ence, and the best way to deal with them. 

Less Sugar. — In the first place, as cow's milk has 
much less sugar than mother's milk, a certain amount 
must be added; this is a necessary article of diet, it is 
not added in order to sweeten the milk. 

More Protein. — Cow's milk contains far more pro- 
tein or curds, and usually more fat or cream than 
mother's milk, and moreover, both of these are far more 
indigestible. We overcome this by the use of diluents, 
and by adapting the strength of the formula to the 
child's individual needs. 

Acidity of Cow's Milk. — Cow's milk is slightly acid, 
but as a rule this never interferes with its digestibility^ 
especially as when first given, it is greatly diluted. 

Mother's milk is always fresh and sterile. Cow's milk 
can never be quite sterile, but by taking great care in 
the milking and preparation, we can make it safe for 
use. 

Selection of Cow's Milk 

Herd Milk. — In the selection of cow's milk for arti- 
ficial feeding, the milk from a mixed herd has been 
found more suitable than that from a single cow, for 
the reason that the milk from one cow is apt to vary 



A MOTHER'S GUIDE 41 

from day to day, whereas the composition of herd milk 
changes very little. 

Holsteins or Jerseys. — The milk of Holsteins or or- 
dinary cows is to be recommended for infants in prefer- 
ence to that of Jersey or Alderney cows, as the milk of 
the latter is very much richer and trouble is almost sure 
to result if due allowance is not made for this when 
preparing the food; for whereas the Holstein and or- 
dinary cow's milk contains four per cent, fat or less, that 
of the Jersey or Alderney contains about five and a half 
per cent. 

Care of the Milk. — As regards the care of the milk 
to be Used for artificial feeding, the chief essentials to be 
borne in mind are that the cows must be perfectly healthy, 
and the milk absolutely fresh and clean. In order to 
insure this, the following rules laid down by the New 
York Board of Health in regard to the care of the cow- 
stables, may be of use. 

Stables. — The cow-stable should be located on ele- 
vated ground with no stagnant water, hog-pen, or privy 
within one hundred feet. The floors should be con- 
structed of concrete, stone, or some non-absorbent ma- 
terial; they should be properly graded and watertight. 
The drops should be of the same material and frequently 
flushed out with water. 

Windows should be such as to insure free ventilation, 
and the interior of the stable should be painted or white- 
washed, and ceiling, walls, and ledges free from de- 
cayed animal or vegetable matter, dirt, dust, manure, or 
cobwebs. 

Feeding troughs, platforms or cribs must be well 
lighted and clean, the bedding used should be clean, dry 
and absorbent, and all manure removed daily to at least 
two hundred feet from the barn, and so placed that the 
cows can not get at it. The liquid matter should never be 
allowed to overflow or saturate the ground under or 



42 HOW TO TAKE CARE OF THE BABY 

around the cow-barn. No sweeping of stables should be 
done within at least an hour before milking time, so that 
the air may be free from dust. 

The water supply for the cows should be unpolluted 
and plentiful, care being taken that there is no stable, 
pile of manure, or other source of contamination within 
two hundred feet of the source of the water supply, and 
a running water supply for washing the stables should be 
located within the building. The cow yard should be 
properly graded and drained and kept clean, dry and free 
from manure. 

Care of the Cows. — A separate building should be 
provided for cows when sick, and also for cows when 
calving. There should be no live stock, other than cows, 
allowed where the milk cows are kept. Cows should be 
examined by a veterinarian and tested by tuberculin, and 
all tuberculous cows rejected. 

The cows must be kept absolutely clean and free from 
clinging manure or dirt, and the long hairs kept clipped 
on belly, flanks, udder and tail. The udder and teats 
tiiust be carefully washed before milking. All feed 
should be of good quality and all grain and coarse fod- 
der free from dirt and mould. The cows should be al- 
lowed to graze freely. 

Milk-Pails. — The milk-pails should have all seams 
soldered flush, and should be of the small mouthed de- 
sign, the top opening not exceeding eight inches. They 
should be rinsed with cold water immediately after using, 
and then washed with hot water and a washing solution, 
and exposed to the sun, on drying racks provided for the 
purpose. 

Milkers. — The milkers should be in good physical 
condition and wear clean clothes and special milking 
suits ; their hands should be carefully washed and wiped 
just before milking. 

Milk from cows within fifteen days before and five 



A MOTHER'S GUIDE 43 

days after calving must not be used. The fore milk or 
first few strains from each teat should be discarded. 
After milking, the milk must be strained through sev- 
eral layers of clean cheesecloth, poured into bottles, 
which have been previously boiled, corked, or sealed, 
cooled in water and then placed in the ice-box in close 
contact with the ice. 

Care of Milk and Ice-Box. — When milk bottles are 
not obtainable the milk can be poured into porcelain or 
glass jugs, but they must be kept covered with several 
thicknesses of cheesecloth, which are kept in place with 
an elastic ring. The cheesecloth must be absolutely 
clean. The temperature of the milk should never be 
allowed to rise above 50° F. The milk bottles should 
therefore be placed on the ice or surrounded by pieces 
of ice. Milk not so kept is liable to go bad and cause 
indigestion. Thermos or vacuum bottles should only be 
used for keeping the milk icy cold. If the milk is al- 
lowed to remain warm it will be unfit for the baby in 
a very short time. Care should be taken that the ice- 
box is kept clean and well scoured, and that no decaying 
vegetable matter is allowed to remain in it. 

Milk more than twenty-four hours old in summer, or 
forty-eight hours in winter, should not be used, unless 
for a journey, and in that case it should be first sterilized 
and then kept on ice until wanted. 

Milk in Cities. — Inspected milk is used in most fam- 
ilies, hotels, etc., and is good for all ordinary purposes. 

Certified milk is nearly double the price, but it is 
purer, and the quality is guaranteed. It should, there- 
fore, be used for babies and delicate children. 

Milk from the Walker-Gordon laboratories is un- 
equaled in quality. These laboratories will make up any 
formulas or prescriptions for modified milk, when it is 
not convenient to prepare it at home. For journeys or 
ocean voyages, they will furnish milk that will keep 



44 HOW TO TAKE CARE OF THE BABY 

fresh and sweet for weeks, if their directions are fol- 
lowed. 

Thunderstorms. — During thunderstorms the milk is 
sometimes soured, even in the ice-box. It is a good plan, 
therefore, to taste the milk after every thunderstorm, 
before making up the bottle. 

Preparation of Baby's Food 

Articles Required for Preparing Food. — The follow- 
ing articles are required for the baby's food, and must 
never be put to any other use. 

1. A nursery refrigerator, preferably of enameled 
metal encased in wood, and arranged so that the bottles 
of milk will be close to the ice. 

2. A small table, with zinc top, or covered with oil- 
cloth, on which the food should be prepared. 

3. An eight-ounce glass graduate. 




CHAPIN CREAM DIPPER 



O 



4. A Chapin dipper for use in top-milk mixtures. 
(Can be bought for twenty-five cents.) 

5. A glass jar, with cover, containing a solution of 
boric acid in which to place the nipples when not in use. 

6. A white pitcher for the hot water in which to 
warm the baby's bottle, and another in which to mix the 
food. 

7. A bottle brush and a nipple brush. 

8. A glass funnel for pouring the mixture into the 
bottles. 

9. A basin containing borax water in which to lay the 
bottles not in use. 



A MOTHER'S GUIDE 



45 



10. An electric heater, Bunsen burner, or alcohol 
lamp, and a saucepan for heating water. 

11. A supply of absorbent cotton and boric acid. 

12. The bottles should be graduated up to eight ounces, 
cylindrical, wide-necked, without angles or corners, and it 
is best to have a separate one for each feeding, and to 
fill each one with the proper amount when the daily 
supply is prepared, as in this way we are sure that the 
mixture is properly shaken and distributed for the day's 
feedings. 





FREEMAN NURSING BOTTLE 



WIRE HOLDER FOR BOTTLES 



A bottle must never be allowed to stand after using, 
and any milk remaining in it should be thrown away. 
It must then be scrubbed with a bottle-brush in hot 
soap-suds, carefully rinsed in hot water, and stood up- 
side down to drain, or placed in a basin of borax water 
(or bicarbonate of soda) until needed. The bottles need 
not be boiled, if cleaned in this way. 

13. A wire holder for keeping the bottles in an up- 
right position in the ice-box. 



46 HOW TO TAKE CARE OF THE BABY 

14. A supply of straight black rubber nipples that 
can be turned inside out, and without holes. It is better 
to make a hole of the required size with a hot cambric 
needle. The hole should be small enough to allow the 
milk to fall in single drops when the bottle is inverted, 
and not in a stream. The nipple should be tested fre- 
quently. Immediately after use, nipples must be thor- 
oughly washed in hot soap-suds and water, inside and 
out, rinsed, and left in the boric acid solution or dried 
and wrapped in sterile gauze. It is better not to boil 
them, except for a minute or so when they are quite 
new, as they deteriorate very rapidly when boiled. 

Cleanliness. — It is most essential that all the uten- 
sils used be kept absolutely sweet and clean, every article 
should receive attention, and the hands of the mother 
or nurse must be carefully washed before beginning 
the preparation of the baby's food. 

Preparation of the Day's Supply. — First dissolve 
the sugar in a small amount of hot water and strain it 
through several layers of cheesecloth if it is not clear, 
then add to it sufficient boiled water or barley water, etc., 
which has been previously cooled, to make up the 
requisite amount. The water to be used for the baby 
should be freshly boiled every day, and kept in a covered 
receptacle until needed. Now add the milk and lime 
water to the sugar solution, mix well, and pour the feed- 
ings into each bottle, stopper them with cotton, place 
for a few minutes in cold water, and then on the ice. 
When they are to be pasteurized or sterilized this should 
be done before cooling. 

To Warm Bottle. — To warm the bottle for feeding, 
place it in a pitcher filled with hot water, and leave it 
for a few minutes; test the temperature by dropping a 
little on the inner part of the wrist. If the temperature 
is tested by tasting, pour a little in a spoon, but never 
touch bottle or nipple to the lips. The nipple is slipped 



A MOTHER'S GUIDE 47 

over the bottle after warming and the bottle well shaken ; 
it is then ready for use. A small flannel bag with a draw- 
string slipped over the bottle will prevent its cooling too 
rapidly during feeding. 

How to Select a Formula 

Main Points to Be Considered. — Before selecting a 
formula, the chief factors to be taken into consideration 
are the age, weight and condition of the child. In young 
infants the weight and condition must be our chief 
guide, the age being of secondary importance. Much 
depends, also, upon whether it is a nursing infant quite 
unaccustomed to the bottle, or one already used to one 
or more bottles a day. 

Weight. — Condition. — The weight of the infant is 
a good guide for the amount to be given, because the 
size of the stomach is usually in direct proportion to the 
weight. To illustrate these remarks, a child of six months 
weighing only eight pounds, whatever its condition might 
be, would receive less than one of the same age weighing 
sixteen pounds. But in the event of the sixteen-pound 
baby's being upset, we may have to give him temporarily 
the same strength of food as the eight-pound baby, al- 
though the quantity would be larger. Here the condition 
determines the strength of the food ; we must give what 
can be digested. For this reason after selecting a formula 
which will give the proper strength of food, we are 
often obliged to vary according to individual needs the 
following details in connection with the feedings : 

1. The amount at each feeding. 

2. The total amount in the day. 

3. The number of feedings in the day. 

4. The length of the intervals between feedings. 

5. The strength of the food and its composition. 
Often No Gain in Weight at First. — When first put 



48 HOW TO TAKE CARE OF THE BABY 

on artificial food, infants often do not gain in weight 
immediately, and this is natural, for the food must be 
made weak until we are quite sure that the child is di- 
gesting it properly. 

When Starting on a Formula. — When called upon 
to select a formula for an infant about whose constitu- 
tion, digestive abilities, etc., we know nothing, always 
begin with a weak mixture, then watch his symptoms 
very carefully ; if these are favorable, gradually increase 
the amount and strength of the food. For instance, a 
child, two months old, weighing ten and a half pounds, 
should get Formula No. 8, but begin with Formula No. 5. 

How to Increase. — Never increase both at once, but 
begin at first with a larger quantity (this increase should 
not be more than one-half ounce at a feeding), and after 
three or four days, if the child does not gain satisfac- 
torily in weight, the food may be strengthened. The 
maximum amounts for its age should not be exceeded, 
for this is liable to distend the stomach unnecessarily. 
(See feeding schedule, page 54.) 

Indications for Increasing the Food. — The younger 
the infant the more rapidly is the step taken from one 
formula to the next, providing all the child's symptoms 
warrant the increase. 

These indications are: 

1. The weight, see page 120, viz., little or no gain. 

2. The digestion. 

Normal stools and absence of vomiting. 

3. Symptoms of hunger. 

The child shows these by taking the bottle very eagerly 
and quickly, by appearing unsatisfied when it is fin- 
ished, and by crying before it is time for the next feed- 
ing. 

All these symptoms being present, it will be advisable 
to try the next formula. If after three or four days 
he still does not gain in weight, but sleeps well and is 



A MOTHER'S GUIDE 49 

comfortable, it is safe to increase still further the food, 
but very gradually, as before. 

The food should never be increased in quality or 
quantity at intervals of less than three days, in order 
to give enough time to observe carefully the effects of 
the former change. 

When Not to Increase the Food. — When a child is 
doing well on a certain formula, is comfortable, sleeps 
well, and is gaining normally in weight, do not on any 
account change the food or select a stronger formula, 
although the one he is taking may be weaker than the 
one laid down in the schedule for his age and weight. 

When an infant is gaining from four to six ounces 
a week or more any increase is inadvisable, even if his 
appetite seems to demand it. Instead, give more water 
between feedings. 

Thirst from Heat. — A child will sometimes be rest- 
less and show signs of thirst in very warm weather, or 
as a result of overheated rooms or too much clothing. 
This may be mistaken for hunger, and the child overfed 
in consequence, whereas the proper treatment under these 
circumstances is to give a drink of warm water between 
feedings. The amount may vary, but a safe guide is 
to give not more than half the amount of the usual feed- 
ing, using water previously boiled and cooled to about 
100°F. A pinch of sugar may be added. This should 
not be given less than one hour before or after the 
feeding. 

When the Increase is Followed by Indigestion. — 
Some infants are slightly upset by an increase in food, 
and in these cases it is safer to return to the old formula 
for a while; then after recovery, to make the increase 
more gradual than before ; e. g., give half an ounce more 
in every alternate bottle at first. 

Indications for Reducing the Food. — The food 
should be promptly reduced, especially in strength, when 



50 HOW TO TAKE CARE OF THE BABY 

the child shows any symptoms of indigestion (see chap- 
ter on Indigestion), or in any case of illness, whether 
trifling or severe. When the symptoms are severe, food 
should be entirely withheld, and only water given until 
the arrival of the physician. 

No hard and fast rules can ever be laid down covering 
all feeding cases. The age, weight, condition and peculi- 
arities of each child have to be taken into account and 
separately considered. 

Food for Healthy Infants 

The Preparation of Suitable Formulas. — In the 
preparation of formulas for the use of infants, it must 
be taken into consideration that while a child can usually 
digest mother's milk, he has to be educated to digest 
cow's milk. As it is impossible to tell beforehand what 
amount of fat or protein a particular infant will be able 
to digest, it is safer to begin with low percentages of 
these ingredients, and gradually increase them until the 
child is taking an amount suitable to his age and weight. 
In this way we shall avoid serious disturbances of di- 
gestion. 

There are five grades of milk which I shall consider, 
differing only in the percentage of fat they contain. 

Different Grades of Milk. — 1. Skimmed milk, con- 
taining about iy 2 per cent, fat; page 59. 

2. Milk from Holstein cows, containing about 3^4' 
per cent. fat. 

3. Milk from a mixed herd, containing about 4 per 
cent. fat. 

4. Milk from Jersey or Alderney cows, containing 
about Sy 2 per cent. fat. 

5. "Top-milk," specially prepared, containing about 
7 per cent. fat. For directions see page 56. 



A MOTHER'S GUIDE 51 

The milk supply in most cities in this country is ob- 
tained from mixed herds, and contains about four per 
cent, fat when supplied by a reliable firm. Jersey and 
other cow's milk containing about five and a half per cent, 
fat is only obtainable from private farms. 

The preparation of top-milk mixtures from the last 
four varieties is explained elsewhere. 

Whole Milk vs. Top-Milk. — Some authors recom- 
mend starting in the first few weeks of life with top- 
milk, or the addition of cream to the milk in order to 
make the mixture richer in fat. As the infant's stom- 
ach is accommodating itself to foreign food, and a dis- 
turbance of digestion at this early period of life is a 
very serious matter, I have found it safer to begin on 
a whole milk mixture of four per cent, fat in proportions 
that we are reasonably sure the child will digest. It is 
a simple matter to add more fat later if we are sure that 
it can be safely borne. This would be done when a slow 
gain in weight and constipation follow the whole milk 
feeding, for these symptoms are easily corrected, while 
the same can not be said of an upset caused by a mixture 
too rich in fat. 

Whole Milk. — We shall then begin with the whole 
milk formulas, and it is understood that whole milk 
(from which no cream has been taken) from a mixed 
herd of cows is to be used, and the bottle thoroughly 
shaken before pouring out the number of ounces re- 
quired. This milk will contain about four per cent. fat. 

Milk from Alderneys. — If, however, only the milk 
from Jersey or Alderney cows is procurable, it will con- 
tain about five and a half per cent, fat, and must be 
treated in the following manner. The milk must remain 
undisturbed in the quart bottle in the ice-box for four 
hours. At the end of that time the upper three ounces 
should be carefully removed with a Chapin dipper. The 



52 HOW TO TAKE CARE OF THE BABY 

remaining contents of the bottle must be thoroughly 
shaken, and from this the milk is poured out for use 
in the formulas. 

SUGAR 

The different kinds of sugars suitable for infant feed- 
ing are described below. 

Milk Sugar. — Milk sugar is most commonly used 
by those who can afford it, but only the best grades, such 
as Squibb's, should be given. The cheaper grades are 
harmful, and are often the cause of inexplicable intes- 
tinal disturbances. 

The amount to be given is mentioned on page 54. (See 
also "Measures/' on page 158.) 

Cane Sugar. — Cane sugar, or the ordinary white 
granulated sugar, is very much cheaper than milk sugar, 
and will suit many healthy babies. Owing to its rela- 
tive cheapness, it is often given in excess, and therefore 
disagrees. As cane sugar is twice as sweet as milk sugar, 
not more than half the amount by measure should be 
given. 

Delicate infants and those suffering from diarrhea 
with much gas will do better on pure milk sugar than 
on cane sugar. 

Malt Sugars. — Malt sugar is very useful in cases 
where the digestion is not normal, and the weight less 
than it should be. It must not be given, however, when 
there is any vomiting or diarrhea. 

There are several kinds in powder form and two kinds 
in liquid form. The former are "Dextri-Maltose" (Mead, 
Johnston & Co/s, Jersey City), "Mellin's Food," "Bor- 
den's Malted Milk," and "Horlick's Malted Milk." From 
two or three level tablespoonfuls of any of these prep- 
arations should be added to every twenty ounces of milk 
mixture. The formulas on page 54 should be adhered 
to, but omitting the cane or milk sugar. 



A MOTHER'S GUIDE 53 

The liquid preparations are "Loeflund's Malt Soup" 
and "Maltzymose." They should be used as follows : 
Prepare the day's feeding without sugar and add two 
teaspoonfuls of either of the above liquids and the milk 
to the barley-water (when the latter has been cooked) 
and bring the whole to a boil. Increase the amount by 
one teaspoon ful every day until the stools begin to get 
loose, then reduce it by two or three teaspoonfuls, until 
the bowels are again normal. These liquid malt sugars 
give a chocolate color to the stools. 

N. B. — 1. Loeflund's Malt Soup is obtainable from Messrs. 
Britt, Loeffler & Weil, 225 Canal St., N. Y. City. 

2. Maltzymose is made by the Maltzyme Co., of Brooklyn, 
N. Y. These preparations can be ordered through any drug 
store. 

Amounts of Formulas. — For the sake of conveni- 
ence, the formulas are given in 20-oz. mixtures. If 30 
oz. are required, it will be easy to add half the amount 
again to those already given, and if 40 oz. are needed, 
the amounts given in the formulas are doubled. On the 
other hand if only 10 oz. are required, we take half the 
amount of everything in the formula. Formulas as given 
below are referred to as "2 in 20" or "5 in 20," etc., the 
two or the five being the number of ounces of milk in a 
total mixture of 20 oz. In this way the mother knows 
not only the number of the formula, but also the propor- 
tion of the ingredients. It must be borne in mind that 
these formulas are only intended for normal, healthy 
infants. 



54 HOW TO TAKE CARE OF THE BABY 



CO 

w 
•J 

Q 
W 
K 
u 

CO 

O 

g 

s 

w 

W 



to 


lO 
rH 


X 


O 


to 


© 

CM 


^ 6 


& 


m O© 


© o© 


rH 


IO 


s 

So 

da 


rH 
rH 


rH 


X 


O 


to 


O 
CM 


rH ° 


rH 


oo2© 


© OkC 


rH 


lO 


rH 


rH 
rH 


X 


o 


CO 


O 
CM 


^ 6 


00 
rH 


^2© 


r-K OlO 

CO m 


ri< 


IO 


CO 

rH 


CO 
rH 


X 


rH 


r-K 
to 


O 
CM 


© o 
6 


a |*-s» 


CO +-» rH 


xH 


IO 


CO 
rH 


CO 
rH 


X 


rH 


CO 


O 
CM 


CO 

00 O 

s 


rH 


© 2© 


© O© 

CO *-rH 


rH 


IO 


CM 

rH 


CM 

rH 


3? 


rH 


t> 


O 
CM 


CO 


© 
rH 


to "^t- 


CO OlO 
CO -^^H 


CO 


© 


CO 

O* m 

-CM 

COrH 

sa 

rt d 


rH 
rH 


rH 


X 


rH 


00 


£ 


CO 

ZO o 

8 


rK 
lO 
rH 


rKOf 

to ** 


CO OCM 
CO *-^H 


CO 


© 


s 


s 


S! 


rH 


© 


O 
CM 


CO 


rH 


10 2© 


© O© 
CO ^C0 


CO 


© 


A 


OS 


» 


rH 


o 

rH 


O 
CM 


to 


CO 
rH 


^2<o 

rH *"* 


t- o© 
CM -mCO 


CO 


© 


00 


00 


rH 


rH 


© 

rH 


O 
CM 


CO* 

coo 


CM 

rH 


rH 2to 


00 OlO 
CM *-C0 


CO 


c* 


s 

CO*. 

ccTS 

as 

co d 


00 


00 


iH 


rH 


rH 

rH 


© 
CM 


(0 

CM 2 

6 


© 


CO 


rH <i-»C0 
CM 


CO 


l> 


c* 


t- 


rH 


rH 


CM 

rH 


© 
CM 


CO 

©:* 




coo^ 


rH OrK 

CM-rH 

CO 


CO 


t- 


CO 


© 


rH 


rH 


CO 
rH 


© 
CM 


to 
rH:* 


00 


co 2^ 


rH O00 
CM *-»CM 


CO 


t* 


\a 


to 


rH 


fH 


rH 


© 
CM 


CO 

CM^ 




^2^ 

CM ^CO 


r4\ OrK 
t' +-»rH 
rH CM 


CO 


l> 


rH 


rH 


rH 


rH 


to 
rH 


S 


O >> 




CM 2C0 


32S 


CO 


t- 


CO 


CO 


rH 


rH 


CO 
rH 


© 
CM 


CO 

T3 


COS 

© 


iS2^ 

rH ^CM 


rf ^ 


CO 


l> 


CM 


CM 


rH 


rH 


rH 


© 
CM 


rH rt 


X 

t- 


rH 2CM 


t-23 


CO 


t> 


rH 


o 


S 


© 


CO 


© 






^ 


© 


rH 


© 




d 

< 

p 

a 

o 

fa 


10 

o 

a 

G 
O 

"o 

jG 


CO 
CD 
CJ 

a 

S3 
O 

j-T 

OS 

S3 
C/i 

I 


(0 

<o 
o 

a 

S3 
O 

vT 

<u 

is 

a 

•— « 


G to 

CO O 


CO 

u 
o 

a 
p 
o 

a 

OS 

S3 

a 

o 
H 


a 
< 


to 

.s 


o 

u 

cJ to 

CU CI) 

** o 

a a 

*• 2 

G ° 

gbfl 

s.2 
< 


U 

o 

G 

3 CO 
O 4> 

11 

H 


CO 

<*> 2 

CD o 
•°'co 

to bfl 

is .a 

•58 

G^ 
j-t 


to 

bD 
a 
'-3 

^co 
Oo 

I.S 


bo 

G 

CJ 
0) 

In 

o 

CO 

It 

G 

o 

n 



A MOTHER'S GUIDE 



55 



It will be noticed that there are no feedings at less 
than three-hour intervals. There is a good reason for 
this, viz. : cow's milk can not be digested under two and a 
half hours, and, as the baby should take his bottle in from 
fifteen to twenty minutes, it is unwise to feed him at a 
shorter interval than three hours. Digestive disorders 
are thus avoided from the beginning. 

Example of feeding according to the above schedule. 



No. of Formula . . 
Age 

Weight 

Amount at each 
feeding 

Total amount for 
the day 

Intervals between 
feedings 

Number of feed- 
ings in the 24 
hours 

Hours for feeding 



Formula No. 10 should be given 
to a child 5 months old 

weighing about 14*/2 pounds. 

Between 5 and 6 ounces should be 
given at a feeding, and 

Between 30 and 36 ounces in the 
24 hours. 

The intervals should be 3 hours. 

There should be 6 feedings in the 
24 hours. 

These are 6, 9, a. m., and 12, 3, 6 
and 10, p. m. 

These formulas are given only as a guide, for it does 
not follow that two children of the same age or weight 
will take the same formulas or amounts. The mother 
should judge by the symptoms of overfeeding or under- 
feeding, as mentioned in the chapter on Nursing, on 
pages 27 and 29. 

Barley Water. — Barley water may be substituted 
for the plain water in the formulas when the infant is 
three or four months old. The nutritive value of barley 
water is very small, but in many cases when the milk is 
not well digested, it helps to break up the curds in the 
stomach, and thus assists in better assimilation of the 
food. 



56 HOW TO TAKE CARE OF THE BABY 

Night Feeding. — In the schedule tinder the headings 
for intervals of three hours, I have recommended the last 
feeding to be given at 10 p. m. instead of 9 p. m., which 
would be the correct hour according to the intervals. I 
have made the change in this case, because it has been 
my experience, that when the last feeding is given a little 
later at this age, babies are more apt to sleep through 
the night without waking, and this habit should be en- 
couraged and the night feeding discontinued as soon as 
possible. 

Larger and Smaller Amounts Given in Schedule. — 
It must be remembered that the lesser amounts given 
are for small-sized and delicate children, and the larger 
amounts for robust, large-sized children. The larger 
quantities should never be exceeded, except in rare 
cases. 

Higher Formula. — A higher formula than the one 
suitable to the child's age (see page 54) is only indicated 
when a baby is taking the maximum amount of such a 
formula and is not gaining, and otherwise shows signs 
of insufficient nourishment (see heading Scanty Milk, on 
page 29), but does not vomit nor show any symptoms 
of indigestion. 

Top-Milk. How to Prepare It. — Let the bottle of 
milk stand undisturbed for four hours in the ice-box. If 
it is herd milk containing 4 per cent, fat, remove 16 oz. 
with a Chapin dipper; if Jersey or Alderney milk is 
used, remove 24 oz. ; if Holstein milk, then only 12 oz. 
The milk taken out in this way will be so-called top-milk, 
and will contain 7 per cent. fat. Shake this and from it 
take the number of ounces required and proceed to make 
up the formulas as before. (See schedule.) When 
using top-milk, a stronger mixture than Formula No. 9 
should not be given. This formula calls for 9 ounces 
of top-milk in 20 ounces, and consequently contains a 
little more than 3 per cent. fat. Very few infants can 



A MOTHER'S GUIDE 57 

stand a higher percentage of fat than this, so after using 
No. 9 formula with top-milk it is wiser to make the 
next step a No. 10 formula with whole milk. 
f- An intermediate stage between whole milk (4 per 
cent, fat) and top-milk (7 per cent, fat) is the milk from 
Jersey, Alderney, or Guernsey cows containing about 
Sy 2 per cent. fat. After shaking up the bottle, use it ac- 
cording to the directions given for milk from a mixed 
herd, but do not give a stronger mixture than Formula 
No. 12, as this would contain slightly over 3 per cent, 
fat. After No. 12 formula with Jersey milk give No. 13 
formula with milk from a mixed herd. 

Remarks. — Personally I am not an advocate of top- 
milk mixtures, except in very rare and special cases. I 
have seen more harm than good result from their use, as 
for most infants the fat or cream in cow's milk is the 
ingredient most difficult of digestion. Children upset 
as a result of too much cream do not recover for a long 
time, and even after recovery require very careful feed- 
ing. 

Top-milk or the addition of cream to an infant's food, 
for the purpose of increasing the percentage of fat in 
the mixture, originated a few years ago from the idea 
of modifying cow's milk so as to make its composition 
the same as mother's milk. 

To explain this, I shall first give a table showing the 
average composition of mother's milk and cow's milk. 

Fat. Sugar. Protein. 

Mother's milk 4% 7 % 1.50% 

Cow's milk 4% 4.50% 3.50% 

As can be seen, cow's milk contains more than double 
the amount of protein and a little more than half the 
quantity of sugar that mother's milk contains. 

To make the cow's milk more like mother's milk, it 
was greatly diluted, and then sugar and cream were 
added. Chemically the two milks were now almost 



58 HOW TO TAKE CARE OF THE BABY 

identical, but in digestibility they were far apart. With- 
out any experience to warrant it, this modification of 
top-milk was at once advocated and tried on infants, 
generally with disastrous results. Many physicians have 
now discarded it. 

The old notion prevailed that all curds in the stools 
were composed of undigested protein, but we now know 
that curds are often composed of fat. The protein of 
cow's milk is not so indigestible as it was thought to be, 
and in most cases of indigestion in infants we can put 
the blame on the cream. 

Do we not all know of children suffering from indi- 
gestion who have been benefited by skimmed milk or 
buttermilk? In both of these the percentage of fat is 
very low, but the protein is the same in amount as in 
unaltered milk. To give cream under these circum- 
stances would be to court disaster. 

Fat a Necessary Ingredient. — Although it is the 
cream or fat that is the ingredient most difficult of di- 
gestion, still it is very often essential for an infant to 
have some form of fat, for it produces heat and energy, 
prevents waste of the tissues of the body, is a natural 
laxative and assists in the growth of bone and nerve 
tissues. Lack of fat produces emaciation, constipation, 
rickets, etc. 

Top-milk would be occasionally indicated in the case 
where the healthy infant is getting the formula suitable 
for his age and weight, but is gaining very little or not 
at all, is constipated, but has no other symptoms. I am 
distinctly opposed to top-milk, but if it is given, the 
infant must be watched very carefully. If the top-milk 
disagrees, we must go back to whole milk or even to 
skimmed milk and give olive oil in small quantities, to 
take the place of cream, for a short time, until the symp- 
toms improve. 

Olive Oil. — As a result of recent experiments it has 



A MOTHER'S GUIDE 59 

been found that a pure vegetable oil, like olive oil, can 
not only take the place of cream, but that it is very di- 
gestible and can be given to infants who could not pre- 
viously tolerate the smallest percentage of cream. They 
do not gain in weight on it, but it prevents them losing. 

Olive oil should be given in small quantities, begin- 
ning with half a teaspoon ful three times a day, just after 
giving the bottle. It may be increased gradually, to a 
maximum of six teaspoonfuls a day, and should always 
be given in divided doses, after each feeding. 

Skimmed Milk. — Skimmed milk is useful in certain 
cases of indigestion and where infants have been upset 
from mixtures too rich in cream, and should be given in 
every case of vomiting until the cause is known. It is 
taken from whole milk by allowing the bottle to stand 
four hours in the ice-box, and then carefully removing 
the upper four ounces with a Chapin dipper. The remain- 
der is shaken up and used in making the required form- 
ula. If the milk is from Jersey cows, remove the upper 
six ounces and use the rest, as before. 

General Directions for Feeding 

Position During Feeding. — For the first two or 
three months the baby should lie in a semi-reclining posi- 
tion in the mother's or nurse's arms for all feedings in 
the daytime. At night, for the sake of warmth, the 
child can be placed on its side in bed, and the bottle held 
in its mouth. An infant requires attention during the 
entire time of feeding, and the bottle must never be left 
lying on the pillow to be sucked at will, as the child 
may draw in air owing to the bottle not being at the 
proper angle ; or he may alternately suck and fall asleep, 
and will be too long over the bottle. A sleepy infant 
may be kept awake by gentle tapping or shaking, but 
if twenty minutes have elapsed, and the bottle is still 



60 HOW TO TAKE CARE OF THE BABY 

unfinished, it should be removed, the milk thrown away 
and no more offered until the next feeding-time. 

After Feeding. — The baby's diaper should be 
changed before giving the bottle, so that immediately 
after the feeding he may be placed in the crib, and not 
disturbed in any way. Playing with or exciting a baby 
at this time is often the cause of vomiting or indigestion. 
If the child is perfectly healthy and comfortable, and 
has been properly trained, he will be quite content to lie 
quiet in his crib after the feeding even if he does not 
sleep. Should he cry, it is well to examine his diaper, 
or to pick him up gently, lay him against the shoulder, 
and pat him gently on the back for a minute or so, as 
a little wind in the stomach may be the cause, and if he 
succeeds in getting rid of it, he will be perfectly quiet 
when replaced in his crib. 

Waking for Feedings. — A baby must be wakened 
through the day for his feedings, and he should be fed 
at regular intervals, and at the exact time by the clock, 
the same hours every day being rigidly adhered to. The 
child will thus be taught regular habits, and in a short 
time will learn to wak of his own accord for his bottle. 

Night Feedings. — After nine or ten o'clock at night, 
however, a baby should be allowed to sleep as long as 
he will and the night feeding given when he wakes of 
his own accord. This feeding should be discontinued as 
soon as possible after birth, and never given, in any 
case, after the child is four or five months old, when he 
should sleep from 10 p. m. to 6 a. m. without waking. 

Time Allowed for Feeding. — Twenty minutes should 
be the regular time allowed for each feeding, and if the 
hole in the nipple is properly regulated it will take a 
healthy baby fifteen to twenty minutes to consume the 
amount. If he takes it in a shorter time he is likely to 
regurgitate or suffer from indigestion. If he drinks too 
eagerly, the bottle should be taken out of his mouth re- 



A MOTHER'S GUIDE 61 

peatedly for a few seconds at a time, but care must be 
exercised in doing this, as a sudden pull on the bottle 
might injure his tongue, which is tightly curled around 
the nipple. 

Intervals. — The intervals which are counted from 
the beginning of one feeding to the beginning of the 
next, should be strictly adhered to, except during severe 
illness or on the advice of a physician. These intervals 
should never be shortened, even in the case of a nursing 
baby, and still less so with a bottle-fed baby, for if a 
fresh feeding is added to a variable amount of partially 
digested food in the stomach, it is sure to result in 
colic, indigestion, vomiting, etc. 

Lengthening of Intervals. — On the other hand, bot- 
tle-fed infants often do better, even in the earliest weeks 
of life, when the intervals between feedings are length- 
ened to four hours instead of three. This is due to the 
fact that it takes cow's milk nearly three hours to digest, 
as has been proved by various experiments. The older 
the child grows, the more milk is consumed, and the 
longer the process of digestion will take, consequently we 
lengthen the periods of time between feedings. They 
should not be less than three hours and not more than 
four hours, depending on the age and condition of the 
child. The intervals should always be lengthened when 
the child suffers from loss of appetite, does not finish his 
bottle, vomits or regurgitates after feeding, or during 
any attack of indigestion or illness. 

Treatment of Healthy Babies. — It has been stated 
that babies should be left undisturbed in their cribs after 
feeding, but this does not mean that a child is to be left 
lying in its crib all day. In fact, it is essential to a baby's 
development that it be carried about in the arms from 
time to time, as this will take the place of exercise for 
a baby not yet able to walk. The times for doing so, 
however, should be before feeding, not after. If it is 



62 HOW TO TAKE CARE OF THE BABY 

seen that a child is crying simply as a result of injudi- 
cious petting, and when it is not uncomfortable in any 
way or suffering from indigestion, he should not be in- 
dulged, but rather allowed to have his cry out, as this 
will do him no harm, and he will soon get back into 
regular habits. Of course, exceptions must be made in 
the case of very sick babies, as these have a right to be 
"mothered," and ought not to be allowed to cry very 
long. They should be indulged, however, only during 
the time of their illness, after which they must be grad- 
ually trained back into their former habits. 

ADDITIONAL FOOD DURING THE FIRST 

YEAR 

(For Recipes, see page 154.) 

Barley Water. — When the child is three or four 
months old barley water may be added to the milk mix- 
ture in place of the water, as it often assists in the di- 
gestion of the milk. 

Gruels. — Gruels, in small quantities, beginning with 
one ounce, may be added to the twenty-ounce mixture in 
place of an equal amount of water after the seventh or 
eighth month, and increased until, at twelve months of 
age, five ounces of gruel are given. The gruel should be 
cooked separately, and added to the milk, then allowed to 
cool a little, after which the other ingredients are added. 

Beef Juice. — This must be diluted with an equal 
amount of cold water. It should be given once a day, 
just before midday or first afternoon feeding. Begin 
with two teaspoonfuls and gradually increase to one 
ounce or eight teaspoonfuls in the course of a month or 
two. Beef juice should always be given after nine 
months of age, but delicate children will be benefited 
by giving it in small quantities as early as six months, 
beginning with one teaspoon ful. At one year, two or 
three tablespoonfuls may be given, but never more. 



A MOTHER'S GUIDE 63 

White of Eggs. — Half the white of a coddled egg 
may be given at six months once a day just before the 
midday bottle and increased to the whole white in a few 
weeks. This is especially useful when the protein of 
cow's milk is not properly digested. Beef juice and the 
white of egg must not be given on the same day, but 
should be served on alternate days. 

Orange Juice. — The juice of a fresh sweet orange 
may be given at six months of age, beginning with two 
teaspoonfuls one hour before the second feeding of the 
day, and increasing the amount to one or two ounces by 
the end of the year. It must always be strained. Some 
children can not take orange juice ; in that case the juice 
of boiled prunes or strained apple sauce may be substi- 
tuted. 

Other Articles of Food. — At nine or ten months, a 
healthy, normal baby can be allowed to munch a zwieback 
or Huntley and Palmer's breakfast biscuit, if he has the 
normal number of teeth. 

In addition, he may be given, three or four times a 
week, the outer mealy part of a boiled potato, finely 
mashed, taken from just under the skin, not from the 
center where it is hard. Begin with two teaspoonfuls 
and gradually increase to one tablespoonful by the end 
of the year. It should be flavored with a little dish gravy 
or beef-juice and a pinch of salt. 

No further additions to the baby's diet should be al- 
lowed until after the first year. 

PROTEIN MILK 

Also Called Casein, Albumin, Eiweiss or Finkelstem's 

Milk 

Protein milk is a preparation of milk particularly suit- 
able for infants and younger children suffering from 
diarrhea with loose, undigested stools. 



64 HOW TO TAKE CARE OF THE BABY 

As protein milk requires a great deal of care and time 
in its preparation, it is advisable, where possible, to get 
this milk from one of the Walker-Gordon laboratories, 
or other reliable dairies which make it. When not pos- 
sible to obtain it, it can be made at home as follows : 

Directions for Making. — Take a quart of whole milk 
and warm it to about 100° F. Add one tablespoonful of 
essence of pepsin or liquid rennet and stir it up. Allow 
to stand about one-half hour or until the milk has cur- 
dled. Then pour it into a muslin bag or through several 
thicknesses of cheesecloth and strain off the whey. The 
whey should be thrown away. Now rub the curds 
through a fine hair sieve, adding one pint of buttermilk 
to it in doing so. When the curds and buttermilk have 
been rubbed through the sieve add enough water to the 
mixture so that the whole amount measures one quart. 
Place on ice until wanted. 

Directions for Giving. — Protein milk is given as 
follows : for infants under six months old, it is at first 
diluted with an equal amount of water, later less water 
is added. Older children can take this preparation un- 
diluted. 

Protein milk alone should not be given for more than 
a couple of weeks. As soon as the diarrhea improves, 
a small amount of malt sugar should be added to the 
protein milk. When this agrees, give the child one bot- 
tle a day with boiled skimmed milk according to his 
age, then gradually increase the number of these until 
the protein milk is no longer used. Slowly return to 
whole milk formulas by taking off less and less cream 
from the top of the milk bottle. 

The protein milk should be made from skimmed milk, 
when the diarrhea does not improve after a few days, 
or whenever there is much vomiting. 



A MOTHER'S GUIDE 65 

PEPTONIZED MILK 

Since the introduction of protein milk, peptonized milk 
is seldom used for indigestion in infancy, but it is occa- 
sionally given to older children during an acute illness. 

Peptonized milk undergoes a change by means of 
which the protein or curds are partially or wholly pre- 
digested. Fairchild's peptonizing tubes are most com- 
monly used for this purpose, and full directions come in 
the package. 

It is more convenient to peptonize the entire day's sup- 
ply at once. 

Milk is completely peptonized by allowing the powder 
to act for two hours before boiling or putting on ice, 
either of which stops the process, but the taste is very 
bitter and it is seldom used. As a rule it should not be 
given for more than a few days. 

Partially peptonized milk, in which the milk has been 
subjected to the action of the powder for ten or fifteen 
minutes only, is not bitter and can be continued for a 
longer time. 

To stop peptonization, bring the milk to a boil, or place 
it on the ice. 

BUTTERMILK 

Buttermilk is useful in many cases of indigestion. It 
can be bought at most large dairies. When not obtain- 
able it should be made from skim milk, which is fer- 
mented by means of various tablets on the market, such 
as Bulgara, lactic acid, etc. Directions come with the 
tablets. Buttermilk should be diluted with water or bar- 
ley water for very young infants, and should not be used 
for more than a few days, unless other foods are then 
added. 



66 HOW TO TAKE CARE OF THE BABY 

STERILIZATION AND PASTEURIZATION OF 

MILK 

These are the two methods in vogue for heating milk 
in order to destroy the germs in it. All milk contains 
germs to a certain extent, no matter how carefully it is 
handled. Most of the germs are harmless, but some milk 
may contain those of typhoid fever, scarlet fever, diph- 
theria, tuberculosis, cholera and diarrhea, etc. 

Sterilization. — Sterilization consists in boiling milk 
for at least one hour in a double boiler. It should then 
be rapidly cooled by placing the saucepan in cold water, 
which is frequently changed, or to which ice has been 
added, so that the milk is cold in about twenty minutes. 
Pour into bottles which have just been boiled, and cork 
them with sterile cotton wool. They should then be 
placed on the ice in the ice-box. 

This milk will keep on ice for two weeks, and can 
therefore be used for long journeys. 

Stale or contaminated milk should never be used as 
food, and sterilization will not make it fit for consump- 
tion. 

Sterilized milk is not so palatable nor so digestible as 
unheated milk, and is often liable to cause constipation, 
and even scurvy if continued as the sole food for several 
months. 

Indications for Sterilization. — Sterilization is indi- 
cated : 

1. During outbreaks of diarrhea, scarlet fever, ty- 
phoid fever, etc. 

2. When the milk has to be kept more than a few 
hours without ice, or when it has to be kept for more 
than twenty-four hours, as on long journeys. 

Pasteurization. — Pasteurization consists in heating 
milk at a temperature of 155° F. to 160° F. for thirty 
minutes. There are several apparatus for this purpose 



A MOTHER'S GUIDE 



67 



on the market, the simplest being the Freeman pasteur- 
izer. It is made in two metals, tin and copper, which 
cost four dollars and eight dollars respectively. It can 
be obtained of J. T. Dougherty, 409 West 59th Street, 
New York City, and from most dealers in surgical in- 
struments. Directions for use come in the box. 

Indications for Pasteurization. — Pasteurization is 
indicated : 

1. When one is not sure how the milk has been han- 
dled, nor whether the cows are in a healthy condition. 

2. In the warm months of the year, whenever the 
milk can not be obtained fresh, as in towns and cities. 




FREEMAN PASTEURIZER 



Pasteurized milk should not be kept for more than 
twenty-four hours. 

When a pasteurizer is not obtainable, the milk can be 
poured into bottles that have just been boiled, then cork 
them with sterile cotton wool and place them in a tin 
pail. Fill the pail with boiling water, cover it up and set 
aside for forty minutes. Then cool rapidly and place on 
the ice. 

Pasteurized milk can be used for several months with- 
out harmful effects, but it^s preferable to use fresh milk 
whenever it is obtainable. 

When in doubt about the quality of the milk, especially 



68 HOW TO TAKE CARE OF THE BABY 

in summer, it is only necessary to bring it to a boil to 
make it safe. Boiled milk should not be used over too 
long a period. 

DIET FROM ONE YEAR TO FIFTEEN MONTHS 

6:30 or 7 a. m. — Warm milk, 6 to 8 oz., diluted with 
2 to 3 oz. of barley or oatmeal gruel, given from a cup, 
and one zwieback. 

9 a. m. — Orange or prune juice, 1 to 2 oz., given 
with a teaspoon. 

10 a. m. — The same as at 6:30 a. m. 
2 p. m. — One of the following: 

a. The white of one coddled egg, later the whole egg, 
or 

b. Two or three tablespoon fuls of beef-juice, or 

c. Mutton or chicken broth, 4 to 6 oz. 

A little stale bread can be broken up in it. Alternate 
these on different days. 

In addition 1 to 2 tablespoonfuls of boiled potato, see 
page 63. 

Warm milk diluted with %. water, 4 to 6 oz. 

6 p. m. — The same as at 6 :30 and 10 a. m. 

10 p, m. — Seven to 10 oz. of warm milk diluted with 
34 water, and given from the bottle. 

Most children should take their meals from a cup or 
spoon at the age of thirteen or fourteen months, except 
the 10 p. m. feeding, which should be given from the 
bottle so as to disturb the child's sleep as little as possible. 

DIET FROM FIFTEEN TO EIGHTEEN MONTHS 

OF AGE 

Note: Many children even at this age can not take 
undiluted milk ; in that case it should be diluted one-quar- 
ter with water. 



A MOTHER'S GUIDE 69 

6:30 or 7 a. m. — Warm milk, 8 to 10 oz., and one 
zwieback. 

9 a. m. — Orange juice, or prune juice, 2 to 3 oz. 

10 a. m. — Oatmeal, hominy, wheaten grits, or corn- 
meal cooked for at least three hours and strained, or 
cream of wheat cooked for half an hour, from one to 
three tablespoon fuls with milk and a pinch of salt, but 
no sugar. 

Also a piece of dry toast, or a zwieback or one Hunt- 
ley and Palmer's breakfast biscuit or bran cracker. 
Also a cupful of warm milk. 
2 p. m. — One of the following: 

a. Beef, chicken or mutton broth, 4 to 6 oz., with well 
boiled rice or bread crumbs, of 

b. One soft boiled egg and 1 or 2 oz. of beef-juice, or 

c. Rare scraped beef ^ to 1 tablespoonful mixed with 
beef-juice or beef broth. 

Also 1 to 2 tablespoonfuls of boiled potato, see page 63. 

And in addition, 2 zwiebacks or 2 H. & P. breakfast 
biscuits, or a piece of cold crisp toast with a little butter 
spread on it. A drink of water, but no milk. 

6 p. m. — Cream of wheat, farina, wheatena or arrow- 
root cooked at least half an hour, about 2 tablespoonfuls 
with milk and a pinch of salt, but no sugar. 

Also warm milk 8 to 9 oz. 

10 p. m. — Warm milk 8 to 10 oz. from the bottle. 

DIET FROM EIGHTEEN MONTHS TO TWO 
YEARS OF AGE 

6:30 or 7 a. m. — Warm milk, 10 to 12 oz., and a zwie- 
back. 

9 a. m. — Orange or prune juice, 2 to 3 oz. 

10 a. m. — One of the cereals, well cooked but not 
strained, 2 or 3 tablespoonfuls, with milk. A piece of 



70 HOW TO TAKE CARE OF THE BABY 

crisp toast and butter, or zwieback, or Huntley and Palm- 
er's biscuits, and a cup of warm milk ; 

2 p. m. — A cup of beef, mutton or chicken broth, or 
2 oz. of beef-juice with a little rice or bread crumbs, 
and one of the following: 

a. One soft boiled egg or poached egg. 

b. A little rare roast beef, or tender rare beefsteak, 
scraped or minced. 

c. A lamb chop, or some of the breast of chicken, cut 
very fine. 

Two zwiebacks, or stale bread with any of the above. 
Also 1 to 3 tablespoonfuls of finely mashed, baked 
white potato with a little dish gravy may be given. 
Also 2 tablespoonfuls of any of the following desserts : 

a. Stewed prunes well cooked and strained; or 

b. A baked apple or apple sauce ; or 

c. Plain rice pudding or cornstarch, or custard pud- 
ding. A drink of water, but no milk. 

6 p. m. — a. Cream of wheat, farina or arrowroot, 
with a little cream and a pinch of salt ; or 

b. Milk toast ; or 

c. Zwieback soaked in warm milk. 

Also a cup of milk with any of the above. 
10 p. m. — A drink of milk for those children who 
do not sleep from 6 p. m. to 6 a. m. 

DIET FROM TWO TO THREE YEARS OF AGE 

7:30 a. m, — Cereals, as before, and an egg, boiled 
or poached. One glass of milk and stale bread, or zwie- 
back, or Huntley and Palmer's biscuits. 

10 a. m. — One cup of milk and a cracker. 

1 :30 or 2 p. m. — A cupful of broth or 2 oz. of beef 
juice and one of the following: beefsteak, chop, roast 
beef, lamb, or chicken, with dish gravy, and a baked 
white mashed potato, or well cooked rice, or spaghetti 



A MOTHER'S GUIDE 71 

and one of the following vegetables : green peas, string 
beans, cauliflower, boiled tomatoes, carrots, spinach, as- 
paragus tips, all cooked soft and mashed, and begun in 
very small quantities. Also one of the following des- 
serts : baked apple, apple sauce, stewed prunes, rice pud- 
ding, junket, bread pudding, custard, cornstarch. Water 
to drink, no milk. 

6 p. m. — Cereals and milk with crackers or stale 
bread, or milk toast, or bread and milk. 

A drink of water should be offered two or three times 
between meals, but a large amount at meal-time must 
not be given ; about half a glassful is sufficient. 

DIET LIST FROM THE FOURTH TO THE 
TENTH YEAR 

Breakfast, 7:30 or 8 a. m. — A choice of one of the 
cereals, cooked for three hours, and served with milk 
and a pinch of salt, but very little cream, and no sugar. 

Stale bread and butter or zwieback, graham crackers, 
oatmeal crackers, or Huntley and Palmer's breakfast bis- 
cuits, or stale rolls. 

A soft-boiled, poached or coddled egg. 

A little apple sauce, or a baked apple, or prune pulp. 

A glass of warm milk. 

Dinner, 12:30 or 1 p. m. — Chicken, beef, or mutton 
broth, with rice or barley. After the age of seven, veg- 
etable puree soups may be given. 

A choice of white fish, flounders, shad or bass, or roast 
lamb, beef or chicken or lamb chop or beefsteak. 

With the meals, only the dish gravy should be allowed, 
and baked or boiled white potatoes mashed up and mixed 
with it. 

Of the vegetables, a choice can be made of spinach, 
green peas, asparagus tips, cauliflower, carrots, stewed 
celery, beets, string beans, squash, lima beans, and after 



72 HOW TO TAKE CARE OF THE BABY 

six years of age, turnips, sweet potatoes, and boiled 
onions. 

For dessert, a choice of custard, junket, rice pudding 
without raisins, any plain milk pudding, or apple sauce, 
baked apple, or stewed prunes, peaches or pears, and oc- 
casionally, a little ice-cream. 

Only water should be given to drink at this meal. 

Supper, 6 p. m. — Milk toast and milk, or cereal and 
milk, and stale bread or zwieback or Huntley and Palm- 
er's breakfast biscuits. Sometimes cocoa can replace the 
glass of milk, but it must not be made rich. 

Three Meals a Day. — After the third year three 
meals a day are sufficient, except that a glass of milk and 
a cracker may still be given between breakfast and lunch 
if a child is hungry and the practice does not lessen his 
appetite for the midday meal, which should be the prin- 
cipal one of the day. 

Regular Hours for Meals. — The meals ought to be 
at regular hours, and any eating between them, with the 
above exception, must be strictly forbidden. Water, 
however, can be given in abundance between meals when- 
ever the child is thirsty, but not more than a glassful 
should be taken at meal-time. 

Milk. — Milk is still a very important item in a child's 
diet, and a healthy child will consume about one and a 
half pints a day, including what is served with cereals, 
in puddings, etc. It often happens that the milk a child 
drinks is better digested if it is still a little diluted, about 
one-fourth part water. Too much rich milk or cream 
is apt to produce loss of appetite and foul breath. 

Fruits. — Sour fruits of any kind should not be 
given at the same meal with milk, as they will cause it 
to curdle. 

Fresh fruit juice early in the morning has a very bene- 
ficial effect on the bowels ; and small quantities of peeled 
pears, peaches, and apples or a few fresh berries can be 



A MOTHER'S GUIDE 73 

given at meal-time, but care must be exercised, especially 
in hot weather. 

Importance of Mastication and Thorough Cooking. 
— Teach children to chew their food very thoroughly, 
and to eat slowly. As they are invariably careless in 
this respect, it is very important that all their meats 
should be cut in very small pieces, and the vegetables 
cooked until very soft, and mashed in addition. Cereals, 
also, should be cooked for a very much longer time than 
stated in the directions on the package. Although they 
are a useful part of a child's diet, hfc must not be allowed 
to eat them in excess, and the ready cooked cereals 
should not be given. 

Importance of Pure Foods. — Only the purest foods 
should be eaten. Whole wheat bread is the only kind 
to buy or bake. For a full description of unwholesome 
foods used in most families the reader is requested to 
read Starving America, by Alfred W. McCann, pub- 
lished by the George H. Doran Company, New York. 

LOSS OF APPETITE 

The most frequent causes of loss of appetite in chil- 
dren are enumerated below. 

Causes. — 1. Sprue or thrush or any other painful 
condition in the mouth or throat causes so much discom- 
fort to a child that he will not take his bottle. His re- 
fusal is wrongly attributed to loss of appetite. (For 
treatment see page 110.) 

2. Eating between meals ; a few crackers or a little 
milk will often take away the appetite for the next meal. 

3. Too frequent feedings or too many meals during 
the day, i. e., the giving of food before the last meal has 
had time to digest. 

4. Eating forbidden articles of food or unsuitable 
food, such as pastry, cake, candy, etc. 



74 HOW TO TAKE CARE OF THE BABY 

5. Exclusive milk diet in children over a year old and 
who refuse to take anything else but the bottle, or too 
large a quantity of any one food, as cereal, etc. This 
condition is difficult to set right, for milk alone is not 
an adequate food at this age and the child becomes 
anemic, nervous and restless in consequence. This can 
sometimes be remedied in the following manner, i. e., 
dilute the milk with an equal quantity of water and give 
the usual amount. Next day, if the child still refuses 
to take other food, dilute the milk still more, viz., one- 
fourth milk and three-fourths water. Very soon the 
child will become so hungry that he will be glad to take 
anything offered him. 

Older children should not begin a meal by drinking 
one or two glasses of milk, — they should take it after 
the meal, but they can have all the water they want. 

6. Too rich milk or too much cream is a frequent 
cause of loss of appetite often accompanied by a coated 
tongue and foul breath. Cream is quite unnecessary for 
children, excepting once a week in ice-cream, etc. Most 
children do better on three parts ordinary four per cent, 
milk and one part water, and when they require more 
nourishment, it should be supplemented by other foods. 

Too rich milk or cream in addition to causing loss of 
appetite is sometimes responsible for congestion of the 
liver, manifested by obscure abdominal pains, extreme 
irritability and light colored stools. 

In one of my cases, a boy five years old was "doubled 
up," had no appetite and complained of pain in the abdo- 
men, and this condition had been diagnosed as appendi- 
citis. It appeared, however, that he had returned from 
a farm the day before, where he had been allowed all 
the rich milk and cream he wanted for two weeks. On 
stopping all cream and milk, the symptoms promptly dis- 
appeared. 

7. Habitual constipation,— -for treatment see page 97 



A MOTHER'S GUIDE 75 

8. Cold baths, with the desire to harden the child, are 
sometimes the cause of loss of appetite, accompanied by 
symptoms of congestion of the liver. (See No. 6 above.) 
If a child does not feel warm and glowing after a cold 
bath, but shivers, has cold hands and feet and blue lips, 
it shows plainly that the cold water does not agree with 
him. 

A boy, seven years old, had had abdominal pains, poor 
appetite and light colored stools for several months, when 
I was called in to see him. On inquiry, I found that 
he had been given cold baths to harden him. He felt 
cold for an hour or more after the bath. After substi- 
tuting hot baths, he had no return of the symptoms. 

9. Insufficient outdoor exercise and want of fresh air 
in the rooms, especially at night. Most rooms are kept 
too hot and are not properly ventilated. 

10. Large adenoids and tonsils of long standing cause 
anemia with loss of appetite. 

11. The onset of any severe illness will usually begin 
by loss of appetite. 

12. There is a fairly common type of loss of appetite 
without apparent cause. It may occur during infancy 
but is more usual after two years of age. The history 
is somewhat as follows : The mother notices that the child 
does not take his food so eagerly as usual, and urges him 
to eat. The child becomes more and more unwilling so 
that the mother, in her anxiety, resorts to various devices 
such as singing and telling stories to distract the child's 
attention, pretending to feed other members of the fam- 
ily, dolls, etc., in order to induce him to take his meals. 

This procedure is, no doubt, familiar to many, as is 
likewise the inevitable result. The child goes on a com- 
plete hunger strike, and is nervously upset, while the 
mother is in despair. The only solution to this trying 
problem is to let the child severely alone. If he is over 
two years of age, give only three meals a day. Put all 



76 HOW TO TAKE CARE OF THE BABY 

the food for the meal on a tray, — for example, a sample 
breakfast would be two tablespoonfuls of cooked cereal 
with two ounces of milk poured on it, six ounces of milk 
in a glass, and a slice of bread and butter. The baby- 
is first offered a teaspoonf ul of cereal and pushes it away. 
The cereal is at once removed from the table without a 
word being spoken. Next the baby is offered a drink 
of milk, this also is refused and taken away. The same 
may happen with the bread and butter. The child may 
not have eaten a mouthful, but the mother should take 
off his napkin and let him down from the table without 
a word being spoken. It is very likely that the child 
will ask for food shortly afterward. He must be sternly 
refused without arguing. He may, however, have all the 
water he cares to drink. The same procedure should be 
followed at dinner and supper. A child can safely go 
five or six days without food. However, it almost in- 
variably happens that in two or three days he will take 
his food ravenously. 

With some children it may be necessary to lengthen 
the intervals between feedings. If the tongue is coated 
and the breath is foul, it is advisable to give a brisk ca- 
thartic and to offer less food at the next meal. 

In summer time, especially, less food, particularly 
meat, is required by a child, but he needs more water 
between meals. 

Supper should always be a light meal, as otherwise a 
child's sleep may be disturbed. 

Peculiarities of Appetite. — Children often develop 
a habit of eating too much of some one article of food, 
to the exclusion of others. In some it may be meat, in 
some cereals, in others vegetables, and a few will take 
so much milk that they have no appetite for anything 
else. While all these foods are excellent in their way, a 
child will thrive much better on a mixed diet. In order 
to teach him to eat what is good for him, it may be ad- 



A MOTHER'S GUIDE 77 

visable to withhold the desired food altogether for a few 
days, and, if necessary, to starve him a little, and begin 
feeding by serving him with whatever food he usually 
refuses. 

FORBIDDEN ARTICLES OF FOOD 

All fried food of any kind, except bacon and the juice 
of bacon. 

Fish. — All fish not mentioned in diet list, and all salt 
fish. 

Meats. — Pork, ham, veal, kidney, liver, rich stews, 
duck or goose and all prepared meats, such as sausage 
or salted meat. 

Vegetables. — Cabbage, corn, fried egg-plant or onions, 
or raw vegetables, or salads of any description. 

Bread. — Fresh bread, hot bread, muffins, hot biscuits, 
doughnuts, griddle or buckwheat cakes, or fresh sweet 
cakes of any kind. 

Desserts. — Nuts, pastry, candy, rich puddings or pre- 
serves, dried fruits, or pies. 

Fruits. — Pineapple, the pulp of grapefruit or oranges, 
cherries, grapes, unless the skins and seeds are removed, 
berries, unless very fresh, and then only a limited quan- 
tity. 

Beverages. — Tea, coffee, beer, wine, or cider, should 
be absolutely forbidden until a child is fifteen or six- 
teen years of age, and lemonade or soda water only 
very sparingly allowed. 

STOOLS 

Normal Stools. — During the first week a healthy 
breast-fed baby should have four or five stools a day. 
For the first three or four days, they are dark brown 
with a tinge of green, and pasty in consistency. They 



78 HOW TO TAKE CARE OF THE BABY 

gradually become lighter, until by the end of the first 
week, they are of a light yellow mustard color, soft and 
pasty, and with a slightly acid odor. After the first week 
a breast-fed baby has from two to four stools a day. 

A healthy, bottle-fed baby has but one or two stools 
a day, and these are of a paler yellow, firmer, larger, 
and more granular. The odor is more pungent, and 
may be cheesy, or foul. 

Proprietary Foods. — After the use of proprietary 
foods, the color of the stools changes to a light gray or 
light brown. 

Drugs. — Iron and bismuth change the stools to a 
dark, almost black color. 

When calomel is given in effective doses, the first por- 
tion of the stool that is expelled may be normal, but the 
last portion is loose and green. This is directly due to 
the action of the drug. 

Curds in the Stools. — When either the fat or the 
protein is not properly digested, it will appear in the stool 
in the form of curds, or whitish round or oblong lumps 
of various sizes. 

Fat curds are small, soft, white or yellowish lumps, 
about the size of a pin's head, or a little larger. Pro- 
tein curds are hard, white or yellowish, shiny, round or 
oblong lumps from the size of a small pea to a fair sized 
bean. 

If the curd is put on a board and pressed with a piece 
of wood, a fat curd will flatten out easily, while a pro- 
tein curd requires some pressure. 

Stools Showing Excess of Fat. — If the trouble is 
excess of fat, the stools will generally be loose and grass 
or light-green, or, rarely, pale gray and in small dry 
lumps, or large, pasty and greasy, with a very rancid 
odor. 

Protein Curds. — Large and hard white or yellowish 
curds, formerly considered due to faulty digestion of the 



A MOTHER'S GUIDE 79 

protein, are now considered the result of milk that is too 
rich in cream. When boiled milk is used, they disappear. 

Stools Showing Excess of Sugar. — Frequent loose, 
green stools, sometimes frothy, and with an offensive, 
sour and pungent odor, and with much gas, are caused 
by excess of sugar, or proprietary foods, which all con- 
tain large amounts of sugar. When this condition lasts 
for a few days the buttocks become red and sore. 

Stools from Overfeeding. — Infants who are overfed 
may have four or five normal stools daily, often immedi- 
ately after feeding ; or they may be more numerous, from 
four to seven a day, and fairly well digested, but contain- 
ing a large amount of mucus. On the other hand, some 
children who are overfed will only have one stool a day, 
and this will be large, light-colored and pasty, with a foul 
odor. 

Inactive Liver. — Pale, almost white, pasty stools 
show inactivity of the liver. A good dose of calomel 
and attention to the diet will remedy this condition. (See 
chapter on Loss of Appetite.) 

Inflammation of the Bowels. — The stools will be 
loose, grass-green in color and contain mucus. This con- 
dition should be treated as a case of severe diarrhea. 

Blood in Stools. — Blood in the stools, except when 
Constipated, is always a sign of a serious condition, which 
should be promptly attended to by a physician. 

Indigestion. — In nearly all severe forms of indiges- 
tion, we find loose, green stools containing curds and 
mucus, and with a foul odor, so that it is often very diffi- 
cult to know where to place the blame. In making a diag- 
nosis, a child's other symptoms must be taken into con- 
sideration as well as the character of the stools. (See 
chapter on Indigestion.) In many cases, no absolute 
diagnosis is possible, without a careful laboratory „ exam- 
ination. 

Stools that are granular with some curds and some, 



80 HOW TO TAKE CARE OF THE BABY 

mucus are not unfavorable if the child is gaining in 
weight. 

The feeding should be made weaker or changed when 
the stools are — 

1. More than five a day. 

2. Very green. 

3. Very foul smelling. 

4. Accompanied by much gas. 

Bright green, watery stools or stools with a large 
amount of mucus should be treated as a case of severe 
diarrhea. 

Brick Red Discoloration. — Normal stools with a 
brick-red discoloration on the napkins signify. that the 
child requires more fluid, especially water. This dis- 
coloration will disappear in a few hours after plenty of 
water has been taken by the child. 

INDIGESTION 

As a child thrives and gains in weight only when his 
food is properly digested, any symptoms showing de- 
rangement of the digestion must receive prompt atten- 
tion, and the cause be rectified. 

Causes. — There are many causes for indigestion, 
most of which are avoidable. The most common are: 
eating too rapidly, eating between meals, too frequent 
meals, coaxing a child to eat when he is not hungry, giv- 
ing only those articles of food which a child craves, 
too much cake or candy, raw or stale fruits, insufficiently 
cooked foods, unsuitable foods, etc. 

Symptoms. — Children suffering from indigestion 
show it in many ways. They do not sleep well, they are 
languid, fretful or irritable, lose their appetite, do not 
gain in weight and look pale. The breath is foul, the 
tongue is coated, the bowels are not normal and they 
complain of pains in the head and stomach. 



A MOTHER'S GUIDE 81 

Treatment. — The bowels must always be emptied 
by a cathartic, calomel if the child is constipated, or cas- 
tor oil if he has diarrhea. 

In nursing infants, the further treatment of indiges- 
tion due to any cause not connected with the mother's 
milk is explained in the chapter on Diarrhea. 

Feeding During Illness. — In the case of a bottle-fed 
baby, the food must never be given full strength when 
he is not in his usual health. For a slight indisposition, 
the milk should be diluted by pouring off one-fourth to 
one-half of the mixture, and substituting the same 
amount of boiled water. Feed less frequently, but give 
plenty of water to drink between meals. In a case of 
acute indigestion, all milk should be stopped for twenty- 
four hours, and barley water or whey given instead. On 
recovery, begin feeding on a low formula, and, at first, 
use boiled skimmed milk or partially peptonized milk. 

Feeding After Illness.— Great care must be exercised 
in returning to the original formula after an illness, as 
when an infant is once seriously upset, he is much more 
liable to similar attacks in the future, and these from 
slighter causes. After any acute indigestion, food should 
be very carefully increased so that the original strength 
will not be reached until after ten or fourteen days. 

Indigestion Caused by Overfeeding. — Overfeeding 
is a frequent cause of indigestion in bottle-fed infants, 
and is often brought on by the mother's desire for the 
child to gain rapidly in weight. It should be remem- 
bered that a child is capable of digesting only a certain 
amount of food, and gains only when that is properly di- 
gested. Any excess is harmful, because it remains undi- 
gested, and will only ferment and cause trouble. Overfed 
and excessively fat babies are usually delicate, and are 
easily upset from slight causes. 

Symptoms. — A child who has been overfed becomes 
restless, fretful and appears uncomfortable. He sleeps 



82 HOW TO TAKE CARE OF THE BABY 

badly, stops gaining or loses in weight, vomits after 
feeding, suffers from colic and wind, and his stools are 
abnormal. He always seems hungry, especially at night, 
and for this reason more and more food is given, thereby 
making the condition worse. An infant habitually over- 
fed has a large abdomen or "pot belly," and often suf- 
fers from rickets. 

Treatment. — In these cases, simply reducing the 
food, giving an amount suitable to the weight ( see sched- 
ule, page 54) and lengthening the intervals, will often be 
the only treatment necessary. 

Indigestion from Improperly Proportioned Food. — 
The digestive capabilities of infants vary so much that 
although the formula suited to the age, weight and condi- 
tion is given, one or the other ingredients may not suit a 
particular child. The amounts of fat, sugar and protein 
may not be excessive, but the child's symptoms will show 
that he is not digesting it. When this happens, a change 
in the food must be made. 

Indigestion from Excess of Fat. — The excess of fat 
may upset the stomach or the bowels, or both. When- 
ever the stomach is disturbed the child will vomit. But 
if the bowels can not handle the amount of fat, then the 
stools may be loose and green with curds and mucus; 
or large, fatty and rancid ; or small, dry and lumpy. In 
any case the child does not gain in weight and may lose 
flesh, although the increase may have been rapid pre- 
viously. 

Treatment. — Make up formulas with skimmed milk 
and if there is no improvement in a day or two, boil the 
milk. If there is much gas, give half the amount of sugar, 
or leave it out altogether. If the symptoms are not bet- 
ter in a few days, give buttermilk or protein milk. 

Indigestion from Excessive Protein. — Recent inves- 
tigations and experiments have shown that indigestion 



A MOTHER'S GUIDE 83 

from protein in the ordinary milk modifications is a myth, 
and the fault should be put on the cream or sugar. When 
there are many curds in the stools, the milk should be 
boiled. 

Indigestion from Excess of Sugar. — Too much 
sugar, or proprietary foods, which all contain large 
amounts of sugar, are sometimes the cause of trouble. 
The child has loose, green, sometimes frothy, sour, or 
pungent stools, and may suffer from flatulence and sore 
buttocks. 

Treatment. — Use half the amount or less of milk 
sugar given in the formula until the symptoms have im- 
proved. 

Chronic Indigestion. — Indigestion in bottle-fed in- 
fants sometimes persists in spite of all changes in the 
milk, and strict attention to all details connected with 
the feeding. When this condition becomes chronic, it 
is necessary to make some radical change in the food. A 
wet-nurse will often be the means of a satisfactory solu- 
tion of this problem. When this is not possible, the use 
of protein milk or buttermilk for a few days will some- 
times help in restoring a child's digestion to its normal 
condition. 

Protein Milk. — This preparation should be used in 
all cases in which the food is not properly digested and 
the stools are loose and foul with curds and mucus, and 
after boiled skimrned milk and other modifications have 
been tried without success. (See protein milk, page 63.) 

Mammala. — A dessicated milk known as Mammala 
can be used in some cases of indigestion where the ordi- 
nary milk does not agree. Directions come with the tin. 

Condensed Milk and Patent Foods. — There are some 
cases where the use of condensed milk or some patent 
food will succeed for a short time when all other forms 
of feeding have failed. Notwithstanding their undoubted 



84 HOW TO TAKE CARE OF THE BABY 

temporary value in many apparently hopeless cases, if 
they are used for too long a time, rickets or scurvy may 
result. 

Sweetened and Unsweetened Condensed Milk.— 
Condensed milk is especially useful when a child has 
intestinal symptoms, colic and wind. It should, how- 
ever, not be continued longer than two or three weeks. 
By that time the child should begin again on a weak fresh 
milk formula. When the sweetened condensed milk is 
used, Borden's Eagle Brand is recommended, begin- 
ning with one part of condensed milk to fifteen parts 
of boiled water for a child three months old, and grad- 
ually increasing to about one part milk to eight parts 
water ; or one teaspoonf ul poured out from the can into 
the spoon and mixed with four ounces of water at first, 
and the strength of this mixture gradually increased by 
taking less and less water until only two ounces of water 
are required to one teaspoonful of condensed milk. Do 
not use less water as the proportion of sugar will be too 
high in the mixture. The milk should not be taken out 
of the can with the spoon, as the amount removed in this 
way varies with the skill of the operator, and is far from 
accurate. 

With the unsweetened brand one does not run the risk 
of giving too much sugar, but it must be used within two 
days after opening the tin, as it does not keep so well. 
One teaspoonful poured from the can and mixed with two 
ounces of water is the full strength, and should not be 
exceeded. If half a teaspoonful of milk sugar is added 
to every three ounces of this mixture the proportions of 
the whole will be suitable for a child three to six months 
old. 

Patented Foods. — Mellin's food, Borden's malted 
milk, or Horlick's malted milk, being free from starch, 
can be given at any age when the child is constipated, 
does not vomit and is not gaining as he should. For di- 



A MOTHER'S GUIDE 85 

rections, see page 52. Starchy foods, with the excep- 
tion of barley water (mentioned on page 55) should not 
be given until a child is over three months old. After 
this age, some of the patent infant foods containing 
starch, such as Eskay's, Nestle's, Imperial Granum, etc., 
can be used for a short time with advantage in some 
cases. 

COLIC AND WIND 

Causes.— In a nursing baby colic is due to too fre- 
quent nursing, overfeeding, or too rich milk. (See 
chapter on Nursing.) 

In bottle-fed babies, the chief causes are overfeeding 
or the giving of indigestible food, especially sugar and 
starchy foods. Constipation, cold feet and giving cold 
food also cause colic. 

Symptoms.— The child cries, draws up its legs, and 
gives evidences of distress. The stomach is hard and 
distended, the hands and feet may be cold, and the face 
pale. Rumbling sounds can sometimes be heard in the 
bowels. 

Treatment. — In mild cases, the stomach should be 
gently rubbed for a few minutes, or the child made to 
lie on its stomach on the mother's lap, and the back patted 
with the palm of the hand. A hot water bottle to the 
stomach is very soothing, and the administration of a half 
teaspoonful of peppermint water mixed with a little hot 
water will often be followed by an eructation of gas, 
which will give great relief. 

If the bowels are loose, a good dose of castor oil, fol- 
lowed by the application of hot compresses to the abdo- 
men will soon relieve the symptoms. In severe or neg- 
lected cases, a hot saline colon irrigation should be given. 

If the bowels are costive, grve calomel followed by 
mild laxatives, and see that the bowels move regularly. 

In sudden acute cases of colic, the food should be 



86 HOW TO TAKE CARE OF THE BABY 

greatly diluted for the next twenty-four hours. In 
chronic cases, feed the child on boiled skimmed milk or 
partially peptonized milk for a few days, then give a 
weaker whole milk formula than before the attack. 

VOMITING 

Vomiting in infants is due to so many causes, that for 
the sake of convenience I shall discuss it under different 
headings, and begin with the most common causes, as 
follows : 

A. — 1 . Overfeeding. 

2. Too rapid feeding. 

3. Too frequent feeding. 

4. Handling or playing with a baby after feeding. 

5. Tight abdominal binder. 

B. — Other causes due to the excess of some ingredient 
in the milk. 

1. Excess of fat (a very common cause). 

2. Excess of sugar. 

C. — Vomiting may be the result of : 

1. Acute indigestion (catching cold). 

2. Chronic constipation. 

3. Habit. 

D. — Vomiting is often brought on in bottle-fed infants 
by: 

1. Indigestible food. 

2. Stale food. 

3. Too strong a food on first trial. 

4. Too frequent changes in the food. 

E. — Vomiting occurs at the onset of certain diseases 
and from some abnormal conditions. 

Nursing and Bottle-Fed Infants. — With the excep- 
tion of the causes mentioned under the heading D, these 
conditions may exist in both the breast-fed and the bottle- 
fed. The chapter on Nursing includes overfeeding, too 



A MOTHER'S GUIDE 87 

rapid feeding, too frequent feeding, also excess of fat 
in the mother's milk; and the details of treatment are 
there explained. Excess of sugar in the mother's milk 
during the last few months of nursing may cause vomit- 
ing, but this is very rare, and would necessitate immedi- 
ate weaning. 

A — 1. Overfeeding, or 2. Too Rapid Feeding. — 
When vomiting is due to either of these causes, it will 
occur immediately after a meal. 

Treatment in Bottle-Fed Infants. — If the child fin- 
ishes his bottle in less than fifteen or twenty minutes (the 
correct length of time), examine the nipple, and replace 
it, if necessary, by one with a smaller hole. If the vom- 
iting continues, the amount of the feeding is probably 
too large, and should be reduced by about two ounces per 
feeding. The intervals between feedings can also be 
lengthened to over three hours with advantage. 

3. Too Frequent Feeding. — In this case it will be 
sufficient to lengthen the intervals between meals to 
over three hours. A child should never be coaxed to 
feed, nor fed at irregular intervals. 

4. Handling and Playing with a Baby. — This very 
frequently produces vomiting when indulged in soon after 
feeding, and should on no account be permitted. (See 
chapter on Artificial Feeding, General Directions for 
Feeding.) 

5. Tight Abdominal Binder. — It is always well to 
examine the clothing of a vomiting infant to see if the 
binder or any other article of clothing is fastened too 
tightly around the stomach or abdomen. 

B. — 1. Excess of Fat. — This condition will be indi- 
cated by repeated vomiting an hour or more after feeding, 
and often by the character of the stools. 

Treatment in Bottle-Fed Infants. — In bottle-fed in- 
fants the treatment for this condition is explained in the 
chapter on Indigestion. 



88 HOW TO TAKE CARE OF THE BABY 

2. Excess of Sugar in Bottle-Fed Infants.— Vomiting 
may result from the use of condensed milk, malted foods, 
or too much cane sugar. It is frequently accompanied 
by flatulence, sore buttocks, and other symptoms. The 
treatment consists in the use of milk sugar only, and this 
in smaller quantities. 

C. — 1. Acute Indigestion. — This is frequently 
brought on by cold hands and feet, and insufficient cloth- 
ing. Vomiting will usually be accompanied by colic, and 
followed by diarrhea. 

Treatment. — The child must be kept warm. For 
treatment in the case of a nursing infant see the chapter 
on Diarrhea. The treatment of a bottle-fed baby is 
given in the chapter on Indigestion under the headings of 
Treatment and Feeding during illness. 

2. Chronic Constipation. — The frequent vomiting 
of a small amount after nearly every feeding is some- 
times due to constipation. This condition may be rem- 
edied by the regular administration of a mild cathartic, 
for a time. 

3. Habit. — Habit is often responsible for chronic 
vomiting, or "spitting up/' and some children develop the 
faculty of throwing up any food they may dislike. It 
takes time and patience to remedy this condition, the 
treatment consisting in reducing the usual amount of each 
feeding, or by nursing for a shorter time, for a few days. 
If the child shows signs of thirst, give water between 
meals. 

D — Vomiting from Errors in Diet. — Faulty diet is 
frequently responsible for vomiting in artificially fed 
children, and chief among the errors is the giving of : 

1. Unsuitable or indigestible food, which irritates or 
overstimulates the stomach. 

2. Stale, contaminated or insufficiently cooked food, 
especially cereals and vegetables. 



A MOTHER'S GUIDE 89 

3. Food to which the child is not accustomed, and 
which has been given in too large an amount. 

4. Too frequent changes in the food. 

General Rule. — Whenever a child vomits repeatedly 
and the mother is in doubt as to the cause, pending the 
arrival of a physician, the treatment should be along the 
following lines: 

1. Give barley water for the first three or four feed- 
ings. 

2. Nurse or feed less, and give water between feedings. 

3. Lengthen the intervals between feedings. 

4. In bottle-fed children, use boiled skimmed milk, 
or in more severe cases, partially peptonized skimmed 
milk, in place of whole or top milk. 

5. Give less sugar of any kind. 

6. Give laxatives, except where there is blood in the 
stools. 

7. If the symptoms do not abate, give a colon irri- 
gation, preferably with a solution of bicarbonate of soda 
in the proportion of one teaspoonf ul to one pint of warm 
water. 

E — Conditions Requiring a Physician's Care. — Vom- 
iting often occurs in certain diseases and conditions which 
require the immediate attention of a physician. Among 
these are the onset of fevers, contagious or infectious 
diseases, and abnormal conditions of the blood, stomach 
and intestines, besides many others. 

Of the latter, two are briefly described below, because 
the first (Acidosis) may become very alarming, and even 
cause death, and because in the second condition (Pyloric 
Stenosis) a mother often makes the serious mistake of 
weaning her infant without consulting a physician, under 
the impression that her milk is to blame. 

Acidosis. — This condition appears mostly in chil- 
dren between two and four years of age, and rarely under 



90 HOW TO TAKE CARE OF THE BABY 

the age of one year. It is caused by the accumulation 
of poisonous products in the blood from the intestines, 
i Symptoms. — Previous to the onset of the attack, 
the child may be "out of sorts," and complain of head- 
ache and slight pain in the stomach. A few hours later 
he begins to vomit all food, water, and even cracked ice. 
The breath often has a peculiar sweet apple odor, and the 
child is drowsy and tired. The glands in the neck may 
swell. A positive diagnosis of Acidosis can never be 
made, however, without an examination of the urine. 

Treatment. — The treatment consists in the free ad- 
ministration of bicarbonate of soda. As much as will 
go on a ten-cent piece should be dissolved in a little water 
and given every hour. If the vomiting does not cease 
in a few hours, a colon irrigation of a solution of bi- 
carbonate of soda in the proportion of one teaspoonful 
to one pint of warm water, should be given. A physician 
should be called at once. 

After recovery, not more than one pint of milk should 
be allowed in the day. 

Pyloric Stenosis. — This is a condition not at all un- 
common in the first few weeks of life. It consists of a 
spasm or narrowing of the outlet of the stomach, so that 
the milk is not passed on, but accumulates, and is even- 
tually vomited. As very little food passes into the 
intestines, there is also marked constipation. Prompt 
medical attention is very necessary to relieve this con- 
dition. 

DIARRHEA 

Nursing Infants. — The cause of diarrhea in a nurs- 
ing baby is usually to be found in the mother's milk and 
the treatment for this is explained in the chapter on 
Nursing. Other causes may be catching a cold, or the 
result of lowered vitality from too much clothing, or 
from heat, especially in the summer months. 



A MOTHER'S GUIDE 91 

Simple Diarrhea. — Nurse less, give plenty of boiled 
water between the feedings, and lengthen the intervals. 
This treatment will usually be sufficient. 

Severe Diarrhea.- — In severe diarrhea, with or with- 
out vomiting, stop nursing for twenty-four hours. 
Give one-half to two ounces of cold barley water, rice 
water, or albumen water, every hour or two. In case of 
great weakness give brandy in small amounts as explained 
later. 

After twenty-four hours nurse for not more than five 
minutes every four hours, and give plenty of boiled water 
between nursings. Gradually return to regular nurs- 
ing after three or four days. 

Bottle-Fed Infants. — The most frequent causes in 
artificially- fed infants are overfeeding, too much fat or 
too much sugar. These have all been considered in the 
chapters on Stools and Indigestion, and the treatment 
explained. 

Diarrhea is often brought on by bad or impure milk, 
or by lack of cleanliness in its preparation, by too fre- 
quent feeding, or by sudden changes in the food to 
which the child is not accustomed. The cutting of teeth 
very rarely causes diarrhea, although it is popularly 
supposed to do so. 

It may also be the result of giving indigestible or in- 
sufficiently cooked food ; or, in the case of older children, 
of fruits and vegetables that are stale or unsuited to the 
child's age. Certain infections or intestinal diseases often 
begin with diarrhea. 

No disease causes more trouble in infancy than diar- 
rhea, and it is a symptom that should never be neg- 
lected. 

Simple Diarrhea. — In ordinary mild cases the onset 
is slow. The child may be restless, sleepless and fretful ; 
he usually suffers from colic and flatulence and may 
vomit. This depends on the severity of the attack. From 



92 HOW TO TAKE CARE OF THE BABY 

twelve to twenty-four hours later the child's bowels be- 
gin to move more often than usual. The stools at first 
are normal, but as they become more frequent, they are 
smaller in amount, and thinner in consistency. The color 
turns to green, and they may later contain mucus. Ten 
or more stools a day are not unusual. 

Treatment. — Every child suffering from diarrhea 
should stay in bed. Begin treatment by emptying the 
bowels thoroughly with castor oil. If the case is a mild 
one, dilute the food one-fourth to one-half with water, 
gradually resuming the usual feeding in two or three 
days. If the symptoms do not abate, stop all milk and 
replace it with barley water or rice water for twenty-four 
hours, with plenty of water between feedings. When 
the symptoms have improved, return to a mixture of 
boiled skimmed milk and greatly diluted, gradually in- 
creasing the amount of milk. If the diarrhea is not bet- 
ter, give protein milk. 

Severe or Summer Diarrhea. — This is a very se- 
vere form of diarrhea, and is known as summer diar- 
rhea because it is most prevalent during the months of 
June, July and August ; July being the month when more 
cases occur than at any other time. It is undoubtedly 
contagious or infectious, and is more often due to im- 
pure or contaminated milk and want of cleanliness than 
to any other cause. This is shown by the fact that babies 
at the breast rarely get it, unless their surroundings are 
unhygienic. Other frequent causes are overfeeding, too 
rich milk, errors in food, warm weather, and a weakened 
condition of the child. 

Symptoms. — With this acute form of diarrhea, a 
child has fever, about 102°-105° F. He is restless and 
sleepless, or listless and apathetic. From twelve to twen- 
ty-four hours after the onset of fever, the stools become 
loose and green and contain curds and mucus. There may 
be anywhere from ten to twenty movements a day, often 



A MOTHER'S GUIDE 93 

accompanied by vomiting. The skin is at first flushed and 
dry, but later becomes pale. The face looks pinched, and 
the eyes are sunken. The child suffers from thirst, and 
his tongue is coated and dry; his hands and feet feel 
cold and may be blue. There is rapid loss of weight and 
the child's whole appearance denotes serious illness. 

Treatment. — A cathartic must be given at once, 
preferably calomel followed by castor oil five hours later 
(for doses, see common remedies, page 158). Give a 
colon irrigation with a saline solution (see Injections, 
page 160). If the child has cold hands and feet, give a 
hot mustard bath (see page 12), wrap him in blankets 
that have been warmed by the fire and place a hot water 
bottle at his feet and one on either side of his body. 

Give the child nothing by mouth except hot water which 
has been boiled and cooled to about 102°F., or as hot 
as can be drunk with comfort, for the first twelve to 
twenty-four hours. This is absolutely necessary to in- 
sure recovery. No greater mistake can be made than 
to give a child food when it is in this condition. Milk 
in any form must be withheld, and rice water or albumen 
water (see page 154) given thereafter until the symp- 
toms improve, but in very small quantities at first. Begin 
by giving two or three teaspoonfuls every hour for two 
or three hours, then an ounce every hour for two or three 
hours, then gradually increasing the amount and length- 
ening the intervals. If the child is thirsty give plenty of 
cool boiled water. 

Children over nine or ten months old can be given 
broths, or bouillon made from chicken, veal or beef. 
If the child is very weak during these days, give small 
quantities of brandy or whiskey as follows : Five drops 
for a child under six months old, ten drops from six to 
twelve months old, fifteen drops over one year, diluted 
in at least two teaspoonfuls of water, and administered 
every three or four hours. This should not be kept up 



94 HOW TO TAKE CARE OF THE BABY 

for more than two or three days, and on no account 
should larger doses be given. 

If the diarrhea does not improve on the second day, 
give another colon irrigation, and repeat it the next day 
if the stools are frequent and very foul smelling, and the 
abdomen is distended. Put a woolen band snugly around 
the child's abdomen. If he is feverish or hot, give luke- 
warm sponge baths every three or four hours, and do not 
put too much covering on the bed. As soon as the diar- 
rhea has improved, give protein milk. (See page 63.) 

Later begin with small amounts of skimmed or whole 
milk previously boiled or pasteurized, and during the rest 
of the summer never give milk that has not been so 
treated. 

Try to resume the original feeding gradually, bearing 
in mind that the child will often not be able to stand 
so strong a mixture as before until the advent of cooler 
weather. Never attempt to return to the original for- 
mula under two or three weeks after the onset of the 
attack. 

No paregoric or patent medicines of any kind should 
ever be given during an attack of diarrhea except by the 
order of a physician. 

Complications.— A mother should not attempt to 
treat a severe case of diarrhea without the advice of a 
physician. Severe diarrhea is sometimes complicated by 
thrush, bronchitis, inflammation of the ear, and con- 
vulsions. 

Rules for Feeding in Hot Weather. — Many severe 
cases of diarrhea could be prevented if proper treatment 
were begun as soon as the first symptoms showed them- 
selves. No slight looseness of a child's bowels should 
ever be allowed to continue in summer-time. Diarrhea 
may often be prevented by taking the following precau- 
tions during the warm season : 

1. Feed at longer intervals. 



A MOTHER'S GUIDE 95 

2. Dilute the food one-quarter to one-half, especially 
at midday. 

3. Make up milk formulas with skimmed milk. (See 
page 59.) 

4. If not sure that the milk is very pure, pasteurize 
or boil it. If it is impure, do not use it at all. 

5. Give a sponge bath two or three times a day if 
the child suffers from the heat. 

6. See that the child's clothing is light and loose. 

7. Give plenty of boiled water to drink between 
feedings. 

8. Keep the child out-of-doors in the shade as much 
as possible. 

9. Be sure that food, utensils and hands are always 
scrupulously clean when preparing the food. 

CONSTIPATION 

Chronic Constipation. — Constipation is not very 
common among nursing infants, but is one of the most 
troublesome conditions among those artificially fed, and 
in older children. If neglected, and allowed to become 
chronic, it is often the cause of a baby's failing to gain 
in weight, and may lead to more serious trouble. 

Warning Against Too Frequent Cathartics. — Be- 
fore giving any treatment the cause must be first deter- 
mined, and the constant use of enemas and cathartics, 
especially castor oil, should not be resorted to, as the 
relief obtained from them is only temporary, and their 
repeated use is very frequently one of the chief causes 
of the disorder. 

Gluten Suppository. — In very young infants consti- 
pation is often the result of inability to make the neces- 
sary effort to expel, and the insertion of a gluten supposi- 
tory will be immediately followed by a normal stool. It 
is only when this condition is joined to symptoms of 



96 HOW TO TAKE CARE OF THE BABY 

indigestion, such as foul breath', restlessness, etc., that a 
cathartic should be given. 

Causes. — The two chief causes of constipation are 
an improper diet and lack of muscular development in 
the intestines. The latter condition is often aggravated 
by neglect, and the failure of the mother or nurse to 
begin early training of the bowels for their daily function. 

Breast-Fed Baby. — If a breast-fed baby is habitually 
costive, it is the mother's diet and regime which should 
receive attention, as it is usually the result of low fat 
in her milk. (See chapter on Nursing, page 23, for diet 
and regime to be followed by the mother.) Sometimes 
the addition of one bottle a day of the regular formula 
will remedy the condition. 

If it is quite certain that the mother's milk is deficient 
in fat, and this can only be definitely known by having 
the milk analyzed, it is sometimes advisable to give the 
baby a little fresh cream and warm water before nurs- 
ing ; the cream should not be bought as such, but should 
rise on the best certified milk, and one or two teaspoon- 
fuls mixed with two or three of water should be given. 
Caution must be exercised with this, for if a little too 
much fat is given, indigestion will be added to the consti- 
pation, and matters will be worse than before. 

Another method of giving the child additional fat if 
the cream does not agree is to administer a little pure 
olive oil after nursing, beginning with half a teaspoonful 
three times a day, and, if necessary, increasing to one 
teaspoonful. One-half ounce a day will usually be found 
sufficient. 

Causes in Artificially-Fed Infants. — In young infants 
who are bottle-fed sluggishness of the bowels may be 
caused by : 

1. Overheating the bottle, thereby almost converting 
it into boiled milk. 

2. Peptonized or boiled milk. 



A MOTHER'S GUIDE 97 

3. Insufficient water, especially in warm weather or 
if the child has been in overheated rooms, or too warmly 
clad. 

4. Continued use of food containing too little solid 
matter, as condensed milk, broth and barley water. 

5. Food containing too small an amount of fat or 
cream. 

With Older Children. — With older children, it may 
also be caused by insufficient exercise, and by giving too 
much starchy food, and too little vegetables and fruit. 

Rarer Causes. — Other causes which are much less 
common are : 

1. General weakness and debility, occurring in rickets, 
malnutrition, etc. 

2. The result of severe and prolonged diarrhea, which 
has weakened the bowels. 

3. Malformation or injury in the lower part of the 
bowels. (This condition is very rare.) 

Treatment. — The treatment in the great majority 
of cases is by attention to the food. It will sometimes be 
sufficient to increase the amount of the food, or to make 
it stronger, but both should not be done at the same time. 

If this does not answer, the cause may be deficiency 
in fat, and this can be remedied by using top-milk (see 
page 56), or by the addition of one-half to two ounces 
of cream to the day's feeding. Another method is to 
give olive oil in the same way as mentioned above. 

Other Methods of Relieving Constipation. — One of 
the malt sugars (page 52) added to the food will often 
produce normal stools, but the milk sugar or cane sugar 
must be omitted. None of these preparations can be 
given when there is vomiting. 

Laxative for Young Infants. — A very satisfactory 
laxative for a young baby is Milk of Magnesia, one-half 
to one teaspoonful in the last bottle of the day, at 10 p. m. 

Caution Against Hasty Changes in Treatment. — 



98 HOW TO TAKE CARE OF THE BABY 

Too hasty changes should not be made in the mode of 
treatment, and any remedy selected should be given a 
fair trial before rejecting it in favor of another. The 
simplest measure should always be tried first, and, in 
any case, plenty of water should be given between feed- 
ings, as this has a very beneficial effect on the bowels. 

Oatmeal Water. — When a child reaches the age of 
three or four months we have a greater choice of meth- 
ods of treatment for constipation. One to be recom- 
mended is the use of oatmeal water instead of plain 
water for diluting the milk. The Health Food Company's 
oatmeal flour is the one generally used, and directions 
for making oatmeal water are given on page 155. Beef 
juice and broths will also be introduced into the diet a 
little later, and these changes in the food will help in 
overcoming habitual constipation. 

Orange or Prune Juice. — After seven or eight 
months of age, orange or prune juice can be given, be- 
ginning with two teaspoonfuls one hour before the sec- 
ond bottle in the morning, and gradually increasing it to 
one or two ounces at twelve months of age. 

Oatmeal Jelly. — After six months of age, well 
cooked oatmeal can be strained and the gruel or jelly 
mixed with the feedings, beginning with one ounce to 
each twenty ounces of mixture. 

At Eighteen Months. — Baked apples and the pulp 
of stewed prunes will be of help in overcoming constipa- 
tion in a child over eighteen months old. After two 
years a few other fruits may be given in moderate quan- 
tities, such as fresh, ripe, peeled pears and peaches, but 
not apples, bananas, or any fruit containing seeds. Fruit 
must never be given in excess in an effort to overcome 
constipation. 

Do not give older children large amounts of oatmeal 
or whole wheat bread in attempting to correct habitual 



A MOTHER'S GUIDE 99 

constipation ; they only irritate the intestines and in many 
cases are passed in a totally undigested condition. 

Castor Oil. — Do not give castor oil as a remedy for 
chronic constipation at any age ; in small doses it is con- 
stipating and in larger ones it will clear out the bowels, 
but will have a costive after-effect, making it necessary 
to repeat the dose indefinitely. 

Oil Enema. — An enema of one or two ounces of 
sweet oil injected slowly into the rectum at bed time 
may sometimes overcome chronic constipation. After 
the injection the buttocks should be held tightly to- 
gether for a few minutes. Shortly after waking up the 
next morning the child will have a good movement of 
the bowels. 

Liquid Petrolatum. — In obstinate cases of consti- 
pation, where every remedy has failed and attention to 
the diet has been without success, we can employ liquid 
petrolatum (Russian oil), which is a pure paraffin oil. 
As it is a mineral product it can not be absorbed by the 
system, but acts solely as a lubricant. It has been used 
for several years in England, but only recently in this 
country. 

This oil can be taken plain or flavored with pepper- 
mint, wintergreen, orange juice, lemon, etc. It may be 
given before or after meals, two or three times a day. 
The amount varies with every child, from one-half to 
two ounces a day, or more. Begin with small quantities, 
such as a teaspoonful three times a day, and increase 
the amount by one teaspoonful a day until good results 
are obtained; thereafter the quantity should be gradually 
reduced. 

Calomel. — A dose of calomel is indicated when there 
is flatulence and the stools are dry, hard and white, but 
it must not be used continuously. 

Importance of Regular Habits. — Above all, remem- 



100 HOW TO TAKE CARE OF THE BABY 

ber the importance of training a child's bowels to a free 
evacuation every day at the same hour. This habit will 
often be the means of preventing many of the ailments 
of childhood. 

MALNUTRITION AND MARASMUS 

Malnutrition and marasmus in infants are different 
degrees of the same condition. The term malnutrition 
may be used to denote a case of digestive disturbance 
with rapid loss of weight for a short time; stationary 
weight, or steady, slight loss for a longer time; this 
becomes marasmus when the condition is aggravated, 
and the child becomes greatly emaciated and still con- 
tinues to lose weight steadily. 

Causes. — These conditions may be the result of tu- 
berculosis, syphilis, and other diseases, but by far the 
most common causes are improper feeding, and persist- 
ing in giving food that is not being digested by the baby. 
Lack of fresh air and unhealthy surroundings are also 
contributory causes. 

Marasmus is more often seen in institutions, but mal- 
nutrition is fairly common everywhere. It is frequently 
due to digestive disturbances brought on by insufficient 
dilution of cow's •milk in early infancy, for although 
there are children who can stand strong mixtures of 
cow's milk from birth, and thrive on it, they are excep- 
tions to the rule. Excess of cream or fat is also a fre- 
quent cause, as is overfeeding, and sometimes excess of 
starch. 

These errors in feeding are often the result of mis- 
taken zeal in trying to make a baby gain weight rapidly. 
This he often does for a short time, without showing 
any signs of indigestion, but suddenly the weight remains 
stationary, and then the child gradually sinks into a con- 
dition of malnutrition and perhaps marasmus. 



A MOTHER'S GUIDE 101 

Irregularity in the hours for feeding, unsuitable food, 
chronic constipation or any other causes resulting in di- 
gestive disorders and imperfect nutrition may also lead 
to marasmus. 

Symptoms and Treatment. — The digestive symp- 
toms vary in different cases, vomiting and diarrhea be- 
ing present in some, and not in others, but a constant 
symptom is steady loss of weight. Infants in this condi- 
tion usually sleep badly and are anemic. 

This condition is one that calls for careful study and 
constant supervision by a physician, and no hard and fast 
rule can be laid down for feeding in these cases. 

Feeding. — If the baby is under six months of age, 
it is advisable to try a wet-nurse. Above that age wet- 
nursing will rarely be successful, and the question of 
feeding is most difficult. In severe cases very weak mix- 
tures of peptonized milk often have to be given for some 
time before any improvement is noticed. In all cases 
the stools and general symptoms must be carefully 
watched. 

If the weight, which has been dropping steadily, be- 
comes stationary, or rises ever so little, do not on any 
account increase the food or change it in any way for a 
few days. 

In some cases too much dilution of food will not 
answer, and a small quantity of stronger food will give 
better results. At other times when fats are badly tol- 
erated, a little olive oil is sometimes useful. 

If the bowels are not loose and there is no vomiting 
the addition of a small amount of malt soup is occa- 
sionally beneficial. The physician, however, will be the 
best judge of this, and his orders must be carefully 
carried out. Many cases of marasmus have been made 
much worse by following the advice of well-meaning 
friends. 



102 HOW TO TAKE CARE OF THE BABY 

Additional Care. — Very intelligent care is required 
from the mother or nurse co-operating with the physi- 
cian, as an infant in this condition has very little power 
of resistance and his chances of life are small if any 
complications arise. Everything possible should be done 
to preserve and increase the child's vitality, as much will 
depend on it. 

Airing and Warmth. — The infant needs an abun- 
dance of fresh air, but he also requires a great deal of 
warmth, particularly as regards his hands and feet. If 
necessary, a hot water bottle should be kept near the feet 
all the time. In summer he ought to be out-of-doors 
all day, in spring or autumn for the greater part of the 
day, and in the winter when the weather is unsuitable or 
too cold he should have an "indoor airing" three or four 
times a day (see Airing). Strict attention should be paid 
to the ventilation of the nursery, but the baby must never 
be allowed to become chilled. 

Salt Bath and Oil Frictions. — A salt-bath should be 
given daily (see Bathing) and followed by a rubbing 
from head to foot with goose grease or cocoa butter. 
Always rub toward the heart, that is, from the ankle 
toward the hip, etc. 

Frequent Changes of Position. — A baby suffering 
from marasmus must not be allowed to remain too long 
in one position; he must be turned occasionally when 
sleeping, and when awake he should be picked up and 
carried about several times a day. He must not be al- 
lowed to cry too much, and especial care should be taken 
to keep him always clean and comfortable. 

Chances of Recovery. — The prospect for a baby's 
recovery is usually more hopeful the older he is, for he 
is apt to have more vitality than in the earlier months. 

Although the improvement in cases of malnutrition or 
marasmus is invariably a very slow process, with proper 



A MOTHER'S GUIDE 103 

care the ultimate recovery is absolute, and after the age 
of three or four years they will be as strong as other 
children. 

Malnutrition in Older Children. — Malnutrition in 
children over two years old is often the result of a pre- 
vious severe illness. They are anemic, nervous, and 
show little resistance to diseases. Disturbances of di- 
gestion arise from slight causes, and they need constant 
care in order to keep them in even moderate health. 
Regularity in feeding, plain diet, no overfeeding, plenty 
of fresh air, no excitement, and plenty of sleep will 
usually result in a successful cure, but the improvement 
will be slow, and constant supervision is necessary. 

COLDS AND THEIR CAUSES 

The Most Frequent Causes. — Colds and their com- 
plications are most frequently brought on in children of 
all ages by the following causes : 

1. Insufficient clothing, easily shown by cold hands 
and feet, blue lips, etc., or too light head covering when 
out-of-doors, especially in young infants. 

2. Excessive clothing, inducing perspiration, with the 
result that cold air often blows on a moist skin and thus 
chills it. 

3. Overheated and badly ventilated rooms, tending 
to lower the child's vitality. 

4. Contact with other children or adults suffering 
from colds. 

5. The use of another's pocket handkerchief. 

6. Kicking off bed covers while asleep. To remedy 
this the blankets should be securely pinned or tied down, 
or a thicker night dress put on the child. 

A Few Rules for Preventing Colds in Infants. — For 
the prevention of colds in infants in arms the following 
advice may be of use : 



104 HOW TO TAKE CARE OF THE BABY 

1. Do not subject a baby to sudden changes of tem- 
perature, such as carrying him from a warm room 
through a cold hall without the addition of extra cloth- 
ing. 

2. Do not hold him near a window in cold weather. 

3. Do not allow the baby to play on the floor in cold 
weather; there is always a draft near the floor. An 
"exercise pen" raised two or three feet is an excellent 
device, as it enables the child to roll about and kick with- 
out running the risk of catching cold. 

4. Never put a baby in a draft in the house or in a 
windy spot out-of-doors. 

5. Keep him out of the dust, particularly if living 
in a city. 

6. Be on your guard against a sudden drop in tem- 
perature in the baby's room at night, and have an extra 
blanket or quilt ready to put over him when necessary. 

Older Children. — With older children wet feet are 
a most common cause of colds. When the stockings or 
shoes are damp they should be changed immediately. 

When children have taken much exercise out-of-doors 
their underclothing and stockings will be moist from per- 
spiration and the skin will be damp. If they stop romp- 
ing or playing, or worse still, stand about in a breeze, or 
go indoors and allow the underclothing to dry on their 
bodies, they are very liable to catch severe colds. All 
damp underclothing should be changed at once and the 
body rubbed down with rough dry towels. 

I have also found by experience that the wearing of 
woolen underwear and woolen stockings by children who 
take much exercise is most conducive to frequent colds. 
Children over eighteen months old should wear cotton 
underclothing only. 

Chronic Colds. — Where children suffer from re- 
peated or chronic colds and coughs, enlarged tonsils and 
adenoids are often the cause. When this is found to be 



A MOTHER'S GUIDE 105 

the case, they should be removed by a surgeon. This 
simple operation is always followed by a marked im- 
provement in the child's general condition. 

When children are over a year old, the chest and back 
should be sponged daily with cold water, followed by 
rubbing, thus rendering the child less susceptible to re- 
peated colds. 

Treatment for Colds. — If the cold is in the head, 
with discharge from the nose, spray it by means of a 
nasal atomizer with warm boric acid, using a solution 
of one teaspoonful to a pint of water, or with a Dobell's 
solution diluted with an equal amount of warm water. 
A few drops of albolene dropped in the nose with a medi- 
cine dropper will also relieve it. 

Treatment for a Cold with Slight Cough.— When 
the cold is accompanied by a cough it is advisable to 
keep the child in an even and warm temperature, and 
preferably in bed. Rub the chest, neck and back, morn- 
ing and evening, with a mixture of half capsicum vaseline 
and half plain vaseline, or with equal parts of camphor- 
ated oil and spirits of turpentine. 

Croup Kettle. — A croup kettle should be a part of 
the furnishings of every nursery, and should be used 
two or three times a day in all cases of colds and coughs. 
The "Simplex" croup kettle is the simplest and is not so 
easily upset as most of the others. It can be obtained 
through J. T. Dougherty, 409 West Fifty-ninth Street, 
New York City. To a pint of water in the kettle is 
added a teaspoonful of Compound Tincture of Benzoin ; 
then a tent is arranged by placing sheets over the crib, 
leaving only space enough to insert the spout of the ket- 
tle. The child should inhale the steam from this for 
fifteen or twenty minutes at a time. If he is old enough 
to sit up, and prefers to do so, the tent can be made by 
raising an umbrella over his head and covering top and 
sides with sheets, closing them in as before. 



106 HOW TO TAKE CARE OF THE BABY 

Additional Treatment. — In addition to this treat- 
ment a simple cathartic, such as castor oil or calomel, 
should be given, as it will help to dissipate the cold. 
When a child has a high temperature, or seems to be in 
much discomfort from a cold, no time should be lost in 
sending for a physician. 

A cold may often be cut short by prompt treatment 
and by keeping the child indoors for a day or two, or 
until the symptoms have entirely disappeared. To take 
a child who is suffering from a cold out-of-doors will 
surely make matters worse unless the weather is very 
warm. 

BRONCHITIS 

Cause and Symptoms. — Bronchitis is often the re- 
sult of a cold that has been neglected. The bronchial 
tubes are the parts affected, and if allowed to remain 
untreated the condition is apt to get worse. It is accom- 
panied by a dry cough and loss of appetite. There is a 
wheezing in the chest, and when the hand is placed 
against it a "purring" can often be detected. There is 
slight fever, about 100°-102°F. 

Treatment. — The child should be kept in bed, in a 
warm, even and moist temperature, and should be made 
to inhale the steam from a croup bottle, as shown in 
chapter on colds (page 105). The food must be simple 
and easily digestible and diluted one-quarter to one-half 
with water, if the patient is an infant. If the child is 
breast fed, one ounce of water should be given before 
putting him to the breast. 

Local Applications. — Local applications are most 
beneficial, and if used early enough will often shorten 
the attack. The mustard plaster is the one most com- 
monly employed and is made as follows : 

Mustard Plaster.- — Mix one part of English mustard 
with five parts of flour, add warm water enough to make 



A MOTHER'S GUIDE 107 

a thin paste and stir. Take a piece of muslin long 
enough and wide enough when folded to go around the 
chest. Spread this on a table and smear the mustard 
paste in the center, folding all four sides up so as to 
close it tightly. Before applying, rub the child's chest 
and back lightly with sweet oil or vaseline to prevent 
blistering. Put the mustard plaster over the chest and 
pin a piece of flannel over it and around the child 
like a bandage. Leave it on for ten or fifteen minutes, 
lifting it from time to time in different places to see if 
the skin is red. When the chest is reddened, remove it, 
wipe the skin dry with a towel and cover the child up 
carefully. 

Other Applications. — In place of a mustard plaster, 
other simpler applications are just as efficacious. When 
obtainable, they have the advantage of being more easily 
and quickly applied and can be rubbed on the neck as 
well. One is capsicum vaseline, which comes in tubes. 
A small amount should be squeezed out and mixed with 
an equal amount of plain vaseline and then lightly rubbed 
over the chest, back and neck. The child should be 
watched to see that he does not get this on his hands 
and then rub his eyes, as it might cause severe inflam- 
mation. 

Another useful application can be made with a mix- 
ture of equal parts of camphorated oil and spirits of 
turpentine. This should be applied in the same way. 

When the bronchitis is of a mild type one of these 
local applications morning and evening will be sufficient. 
In severe cases it might be necessary to repeat them 
every four or five hours, and as the symptoms improve 
they can be discontinued. 

To Relieve the Cough. — To relieve the cough it is 
best to consult a physician. In his absence Brown mix- 
ture can be administered. For doses, see page 159. The 
use of the croup kettle will often assist in breaking up 



108 HOW TO TAKE CARE OF THE BABY 

an obstinate cough. For directions, see chapter on 
"Colds." 

It is very important to keep a child indoors in an even 
temperature until all symptoms have disappeared. A 
cough is only prolonged by allowing him to go out-of- 
doors too soon. 

HICCOUGH 

Hiccough is usually caused by irritation of the stomach 
an.d bowels, either from gases or excessive amount of 
food. It is sometimes caused by taking the food too 
quickly or too hot. 

It can be relieved by a dose of rhubarb and soda mix- 
ture (page 160). A colon irrigation will sometimes re- 
lieve it. Plain cooking soda, one-quarter teaspoonful dis- 
solved in a tablespoonful of water, will often give relief. 

SPASMODIC CROUP 

This is a spasm of the vocal chords, following a ca- 
tarrh of the larynx, and usually occurs in young children. 

Symptoms. — Some hoarseness and cough are noticed 
in the daytime. The child goes to sleep comfortably and 
an hour or more afterward wakes up suddenly with a 
loud barking metallic cough, anxious face, and great 
difficulty in breathing, and appears to choke. It is most 
alarming, but there is really no danger if the proper 
treatment is given at once. The temperature may be 
slightly raised. 

Treatment. — Give the child at once a teaspoonful 
of wine of ipecac, or sirup of ipecac, one of which 
should always be kept in the house, and repeat this dose 
every ten minutes until he vomits. One or two doses 
are usually sufficient, but no harm can be done by re- 
peating it until he gets sick. He will bring up his food, 



A MOTHER'S GUIDE 109 

as well as some mucus, and will then feel greatly re- 
lieved. 

The room should be kept warm, and the child should 
be made to inhale from a croup kettle (see Colds). If 
a croup kettle is not available, he can inhale the steam 
from an ordinary kettle. Relief is often afforded by 
warm compresses or flaxseed poultices alternating with 
compresses wrung out of ice-cold water and applied to 
the throat. To make the air of the room moist, wring 
some towels out of hot water and hang them on chairs 
or ropes stretched across the room. Keep the child in 
this room and moist atmosphere for the next few days. 
He may have another attack the same night, or for the 
next two or three nights. He should be given a cathartic, 
and his diet should be reduced. If he is not relieved 
after vomiting, and the breathing is not improved, be 
sure to send for a physician at once. 

EAR-ACHE 

Causes. — Ear-ache often follows coughs and colds 
in the head, influenza (grippe), pneumonia, measles, etc., 
and may be present in any run-down condition. 

Symptoms. — Infants suffering from ear-ache have 
fever, and show a high temperature, 102°-105°F., are 
restless or drowsy, have little appetite, and may vomit. 
They may move the hand up to the ear, and usually toss 
the head from side to side violently. Children old 
enough to talk naturally complain of the pain and show 
the above symptoms as well. 

Treatment. — A physician should be consulted, as 
in many cases incision of the drum is necessary, and will 
give immediate relief. In the meantime heat should be 
applied to the ear in the form of hot compresses, a bag 
containing hot salt, or a hot water bottle. The ear should 
also be irrigated with a hot boric acid solution, one tea- 



110 HOW TO TAKE CARE OF THE BABY 

spoonful to the pint, from a fountain syringe suspended 
or held two feet above the child's ear. The nozzle should 
be held from one-quarter to one-half inch from the open- 
ing in the ear. This process should be repeated every 
three or four hours. If the ear is already discharging, 
it should be irrigated at least three times a day until no 
more ptis is seen. The length of time that an ear dis- 
charges varies very much. If the drum is opened early 
by a physician the discharge may stop in a week, and 
seldom lasts longer than three weeks. When the drum 
has burst of its own accord the discharge may continue 
for many weeks. 

SPRUE OR THRUSH 

Cause. — When an infant's mouth or feeding uten- 
sils are not kept perfectly clean he is apt to get sprue or 
thrush. This consists of a minute fungus growth, which 
thrives on the tongue and inner sides of the cheeks, but 
may spread to the throat. Sprue has the appearance of 
small particles of curdled milk, each about the size of a 
pin's head. Any attempt to wipe them off will cause 
slight bleeding. 

Symptoms. — It usually occurs in a bottle-fed baby, 
and the first symptoms noticed are loss of appetite, re- 
fusal to take the bottle, and peevishness, the reason for 
this being that the mouth is sore and sucking is painful. 

Treatment. — The treatment is simple. The bottle 
and nipples must be kept clean. A solution of one tea- 
spoonful of soda bicarbonate to three ounces of water 
should be rubbed on all the white spots. To one end of 
a piece of wood a little smaller in diameter than an ordi- 
nary lead pencil attach a little absorbent cotton and twist 
it round to make a swab. This is better than using a 
finger. The mouth should be treated in this way after 
each feeding. The spots disappear in about a week. The 



A MOTHER'S GUIDE 111 

amount of sugar in the child's food should be reduced 
by one-half for the next week. 

ENLARGED GLANDS 

Glands of the Neck. — The glands of the neck be- 
hind and under the jaw, and below the ear, often swell 
to a large size. This is always caused by some infec- 
tion, and may be due to one of the contagious or in- 
fectious diseases, influenza or catarrh, malnutrition or 
marasmus, decayed teeth, or enlarged tonsils. When 
glands have existed for a long time, tuberculosis may be 
the cause. 

Sometimes the child is otherwise perfectly well, and 
the glands appear quite suddenly. In the majority of 
cases these sudden swellings are not in any way serious ; 
they often disappear gradually. Occasionally they break 
down and require incision to let the pus escape ; but this 
is a simple matter and recovery is complete. 

It is always advisable to consult a physician in regard 
to these cases. 

ADENOIDS 

Adenoids are soft, glandular, whitish masses which 
grow on the roof of the pharynx near the posterior open- 
ing of the nostrils, thus obstructing the free passage 
of air. 

Symptoms. — There are few conditions that are re- 
sponsible for more disorders than adenoids. During the 
colder months of the year, and especially in moist locali- 
ties near the sea level, children with adenoids have con- 
stant colds in the head, persistent cough and recurring 
attacks of bronchitis. 

Adenoids are the cause of children snoring at night, 
also of restless sleep and night terrors. Children having 
large adenoids breathe entirely through the mouth, and 



112 HOW TO TAKE CARE OF THE BABY 

when the condition has existed for some time they have 
a vacant and stupid expression, with the lower jaw 
drawn down and a pinched-looking nose. 

Adenoids are often responsible for deafness, inflam- 
mation of the ears, and anemia, and they predispose to 
diphtheria and tuberculosis. Stunted growth, backward- 
ness and nervousness are directly traceable to them. 

Treatment. — Prompt removal by operation is the 
only treatment. The operation is a slight one, scarcely 
ever attended by danger, and is followed by immediate 
improvement. 

It is seldom necessary to operate on children under 
one year old. 

TONSILS 

The tonsils are two soft glands, one on each side of 
the throat, near the base of the tongue. 

Symptoms. — Large tonsils are responsible for fre- 
quent inflammation of the throat, resulting in coughs, 
bronchitis, tonsilitis, anemia, etc. A child with large 
tonsils is more susceptible to diphtheria, scarlet fever, 
tuberculosis and rheumatism. 

Treatment. — Children with large tonsils and a his- 
tory of repeated attacks of sore throat and its many com- 
plications should be operated on for removal of the ton- 
sils. In skilful and experienced hands the operation is 
seldom dangerous. 

WORMS 

Varieties of Worms. — Worms are found chiefly in 
older children, nursing babies and infants being practi- 
cally free from them. The most common varieties are 
the tapeworm, the roundworm and the thread or pin- 
worm. A diagnosis of this condition can only be made 
after finding the worms in the stools. 

Symptoms. — Symptoms may be altogether absent, 



A MOTHER'S GUIDE 113 

or they may be indefinite or misleading. There may be 
bad breath, loss of appetite, colic, diarrhea, anemia, in- 
tense itching of the anus, and various nervous derange- 
ments, such as headache, dizziness, etc. 

Tapeworm. — This worm is from ten to thirty feet 
long and not more than one-third of an inch wide at its 
widest part. It is composed of hundreds of small seg- 
ments, and is flat like a tape. 

Roundworm. — This varies in length from four to 
ten inches and looks very much like the ordinary earth 
worm. 

Threadworms* — These are from one-third to one- 
half of an inch long and look like small pieces of white 
thread. Although the worms themselves often can not 
be found in the stools, their eggs can nearly always be 
detected with the aid of a microscope. 

Treatment. — The treatment should be left in the 
hands of a physician. 

NIGHT TERRORS 

Symptoms. — It is not at all unusual for young chil- 
dren to wake up suddenly at night, crying loudly, and 
apparently in great fear of some one or something. 
They are quieted with difficulty, and for a few moments 
hardly seem to recognize those about them. These at- 
tacks may occur with great frequency or only at long 
intervals. 

Causes and Treatment. — In nearly every case the 
cause is due to some disturbance of the digestive tract. 
It may be constipation or indigestion following over- 
eating or eating some indigestible food. Occasionally 
worms, or enlarged tonsils, or adenoids may be respon- 
sible for these attacks. 

When the attack is due to indigestion it will be suffi- 
cient to give a cathartic and regulate the diet carefully, 



114 HOW TO TAKE CARE OF THE BABY 

particularly as regards the evening meal, which must be 
very light. This usually effects a cure. During the 
attack treat the child kindly; scolding will only make 
him worse. 

RETENTION OF URINE 

Cause. — The most common cause of this condition 
is highly acid urine. It may also result from inflamma- 
tion of the genitals, from an infection or from want of 
cleanliness. In boys it is sometimes due to inflammation 
and marked swelling of a tight foreskin, which has never 
been pushed back, and under which a lot of white, pasty 
material has been allowed to accumulate. 

Treatment. — If no water has been passed for twelve 
hours, place the child in a hot bath at a temperature of 
about 105 °F. This will usually have the desired effect. 
If not, give a hot enema with one pint of hot water to 
which one teaspoonful of salt has been added, and at 
the same time put a hot compress over the region of the 
bladder or the lower part of the belly. Catheterization 
is rarely necessary, and should be done by a physician 
only. 

In boys with swollen parts, a cold, wet dressing with 
a solution of boric acid should be applied after the hot 
bath or enema, and if the swelling does not diminish after 
a few hours of these applications, a physician should be 
sent for. 

In girls, when there is inflammation of the parts, a 
small pad of cotton or linen soaked in a warm solution 
of boric acid, should be applied and changed every two 
hours, after gently washing the parts with boric acid 
solution. If the inflammation does not subside, or if a 
yellow discharge is noticed, a physician should be noti- 
fied, as it is very contagious. 



A MOTHER'S GUIDE 115 

Parents are often mistaken as to the amount of urine 
voided. If a large pad of absorbent cotton wool is placed 
over the genitals and examined from time to time, they 
will be able to judge the amount more correctly. 

JAUNDICE 

About one-third of children born become jaundiced 
or yellow in the latter part of the first week of their 
existence. The yellow color in the skin is most marked 
on the face and chest and in the eyes. The color lasts 
only a few days in most cases, and no alarm need be felt. 
No treatment is necessary. 

THE TEMPERATURE 

How to Take the Temperature. — Examine the ther- 
mometer and see that the mercury is below 97° F. ; if not, 
shake it. Oil the bulb with a little vaseline, place the 
child with his stomach on your lap and expose the but- 
tocks; separate the folds with one hand and insert the 
thermometer gently into the rectum with the other for 
about an inch and hold it there for from one to two min- 
utes, depending on the kind of thermometer. After read- 
ing the temperature, wash the thermometer in cold water 
and soap. It is well to shake the mercury down after 
use, as it is liable to be forgotten later on and mistakes 
made. When a child is sick in bed, turn him over on 
one side and draw his thighs up and proceed as before. 
The temperature is normal when it is between 98° and 
99^° F., with occasional slight fluctuations. 

A separate thermometer should be kept for the baby's 
use and not used for other children. 

High Temperatures in Children. — It must be re- 
membered that slight causes often produce high tempera- 



116 HOW TO TAKE CARE OF THE BABY 

ture in young children for a short time, and that this is 
not apt to be so serious as the same temperature in an 
adult. Even a temperature of 104° need not cause alarm 
unless it is continued for more than a few hours or the 
child shows other serious symptoms of illness. 

Nervous children or those recovering from an illness 
often have a temperature slightly above normal for days 
at a time. 

In any illness accompanied by fever the temperature 
is nearly always higher toward evening than in the 
morning. 

In fever the urine is always scanty and highly colored, 
staining the diapers yellow or brick-red. In this case 
the child requires more water to drink. 

Subnormal Temperature. — When the temperature 
is below normal, put the child to bed, wrap him up in 
warm blankets and place hot water bottles at his feet 
and at the sides of his body. If possible, give him a cup 
of hot milk. If he does not get warm soon, give him a 
very hot saline colon irrigation. 

EXAMINATION OF THE THROAT 

How to Examine the Throat. — A mother should be 
able to examine her child's mouth and throat so that she 
may recognize any abnormal condition. She should make 
a practice of looking at them from time to time, especially 
whenever the child coughs or shows any signs of illness. 

The child should be held by the nurse, so that its back 
rests against her right shoulder; she then passes her 
right arm around the child's chest and holds his two 
arms, while her left arm supports his body. The mother 
with her left hand steadies the child's head and with a 
tongue depressor or spoon opens the child's mouth gently, 
examines the tongue and gums, and then depressing the 
tongue with the handle of the spoon, examines the throat. 



A MOTHER'S GUIDE 



117 




EXAMINING THE THROAT 



118 HOW TO TAKE CARE OF THE BABY 

If no second person is available, the child's arms may 
be controlled very efficiently by winding a folded sheet 
about its arms and body and securing it with a safety-pin. 

TRAINING OF BOWELS AND BLADDER 

Training of Bowels. — The training of a child's 
bowels should begin at about the second month, and can 
be done in the following manner: A small chamber is 
placed between the nurse's knees, and on this the baby 
is seated, taking care to support his body firmly and to 
brace his back against the nurse's chest. At first it may 
help to insert a little cone of oiled paper or a small stick 
of soap into the orifice and to tickle it gently for a few 
moments previous to seating him on the chamber, but 
after a short time this will not be necessary, when once 
the habit has been formed. 

Suitable Hours.— As a normal baby has from one 
to two movements a day, he should be trained to have 
them at the same hours. Twice a day, immediately 
after the morning and afternoon feedings, is the most 
convenient. If this is kept up with regularity, and 
the baby is in good health, he can sometimes be 'trained 
in this respect as early as the age of three months. The 
comfort of forming this habit at the earliest possible 
age will be readily appreciated, as it means a great sav- 
ing of labor ; and it is also beneficial to the child's health, 
as it will be conducive to regular movements of the 
bowels throughout childhood. 

Training of Bladder in Daytime. — The training of 
the bladder is not so easily accomplished, but a great deal 
can be done by the practice of holding a child over the 
chamber about a dozen times a day. In many cases this 
is so successful that by the end of the first year diapers 
can be dispensed with entirely during the child's waking 
hours. 



A MOTHER'S GUIDE 119 

Bed Wetting. — At night, a child's bladder is rarely 
under his control until he has reached the age of two 
and a half or three years. After three years bed-wet- 
ting may be considered abnormal, but is of frequent 
occurrence. It is very seldom a symptom of any blad- 
der or kidney trouble, but the most frequent causes are 
acidity of urine, malnutrition, bad condition of the nerv- 
ous system, heredity, constipation and local irritation. 
Once it has become a settled habit and the child has 
reached the age of five or six years it is difficult to cure, 
unless the cause should be entirely local, such as tight 
foreskin, etc., when a physician should be called upon to 
remedy the condition. 

R6gime to be Followed. — Attention should be paid 
to the child's general condition and to the state of his 
nerves. One should also be particular to keep him on a 
simple, nourishing diet and not to allow him any excite- 
ment. His urine should be examined by a physician. 

No Water or Milk After 4 p. m. — In addition to 
this he should be given plenty of fluid early in the day, 
but none whatever after 4 p. m., receiving a dry supper 
before going to bed. He should be taught to hold his 
urine as long as possible during the day, in order to 
accustom the bladder to full distension. 

Cold Hip Bath. — Just, before bedtime his buttocks 
and genitals should be immersed in cold water for a min- 
ute or two and the spine should also be sponged. 

Sleeping on Side. — The bed covering should be 
fairly light, and the child should be encouraged to sleep 
on his side and not on his back. This can be done by 
tying a piece of thin material about the chest with a knot 
on the back between the shoulders. At 10 p. m. or 11 
p. m. every night he ought to be taken up. 

Some Cases Resist Treatment. — In spite of all these 
measures there are some children who still continue bed- 
wetting until nearly up to puberty, when the habit will 



120 HOW TO TAKE CARE OF THE BABY 

cease for no apparent reason. It is a weakness common 
to both sexes, and some are also affected with slight 
dribbling during the day. 

Punishments and Rewards. — It must be remem- 
bered that at night, bed- wetting is often almost entirely 
involuntary. Punishments are never of any use. On the 
other hand, by offering rewards and appealing to a child's 
pride, more will often be accomplished ; but at best it is 
a very difficult habit to break and the cure usually takes 
a long time. 

It is advisable to leave the treatment in the hands of a 
physician. 

DEVELOPMENT 

Weight of average normal child : 
At birth, 7^4 lbs., more or less. 
At 1 week, 6^4 lbs., losing half pound until mother's milk 

secretes. 
At 10 to 14 days, 7% lbs., same as at birth. 



;. fGaii 



At 1 month, 8*4 lbs. 

At 2 months, IOJ/2 lbs. \- Gain about 6 T / 2 oz. a week. 

At 3 months, 12 lbs. 

At 4 months, 13y 2 lbs. 

At 5 months, 14j/2 lbs. \- Gain about A% oz. a week. 

At 6 months, 15j4 lbs. 

At 7 months, \6y 2 lbs. 

At 8 months, 17 y lbs. Y Gain about 3 oz. a week. 

At 9 months, 18 lbs. 

At 10 months, 18^4 lbs, 

At 11 months, 19j4 lbs. J-Gain about 2y 2 oz. a week. 

At 12 months, 20 lbs. 



A MOTHER'S GUIDE 121 

And thereafter five pounds a year for every year until 
the eleventh birthday, thus, at 

2 years 25 lbs. 

3 years 30 lbs. 

4 years 35 lbs. 

5 years 40 lbs. 

6 years 45 lbs. 

7 years 50 lbs. 

8 years 55 lbs. 

9 years 60 lbs. 

10 years 65 lbs. 

11 years 70 lbs. 

For the next three years a child gains about ten pounds 
a year, thus, at 

12 years 80 lbs. 

13 years 90 lbs. 

14 years 100 lbs. 

Most mothers expect infants to gain six to eight ounces 

a week during the first year, and this often leads to 
overfeeding. During illness children lose weight very 
rapidly, but when convalescent they often regain their 
weight equally rapidly, as much as six to eight ounces 
a week. 

Until it is a year old a child should be weighed once 
a week at a fixed hour, most conveniently just before the 
bath. Delicate or sick children should be weighed twice 
a week. A record of the weights should be carefully 
kept. No comparison with the weights of other people's 
babies should be entertained, as no two babies grow up 
alike, and a mother should not be discouraged when her 
baby does not gain in weight according to the schedule. 
At times, especially during the warm summer months, 
some babies gain very little or not at all, but they are not 
on this account to be overfed. A continuous increase of 
seven ounces a week is rare and is apt to end in trouble. 
Gain in weight is often arrested by trifling disturbances 



122 HOW TO TAKE CARE OF THE BABY 

of health, as slight cough, cold in the head, constipation, 
teething, etc. 

Scales. — There are many baby scales on the market 
at a reasonable price, from three dollars and a half up. 
Scales consisting of a basket supported on springs, 
which work a needle on a dial, are not reliable, as the 
springs either get out of order or get weaker by usage, 
besides the reading of the weight is uncertain whenever 




BABY SCALE 

the baby is restless. All reliable hardware manufac- 
turers, such as Howe or Fairbanks, have a variety of 
suitable scales from which to make a choice ; they should 
read as low as one-half ounce. 

Height. — At birth, 20 inches ; at 6 months, 25 inches. 
One year, 28^4 inches, a growth of Sy 2 inches in the year. 

2 years, 32 inches, a growth of 3^ inches in the year. 

3 years, 35 inches 

4 years, 38 inches ! a th of 3 inches in the 

5 years, 41 inches 

6 years, 44 inches 






A MOTHER'S GUIDE 123 

7 years, 46 inches ^ 

8 years, 48 inches I a growth of 2 inches {n the year _ 
\? years, j\) mcnes i 

10 years, 52 inches J 

Muscular Development. — At 3 or 4 months a child 
can hold his head up ; at 4 or 5 months he laughs aloud ; 
at 6 months he reaches for toys ; at 6 or 7 months he 
can sit erect ; at 9 or 10 months he tries to get on his 
feet; at 12 or 13 months he can walk alone; at 14 or 15 
months he can run about. 

Speech. — At 1 year a child can use single words. 
At 2 years a child can use short sentences. 

Teeth. — A child has 20 milk teeth and they make 
their appearance as follows: 

At 5 to 8 months 2 lower central incisors. 

At 8 to 12 months 4 upper incisors. 

At 12 to 18 months....... 2 lower lateral incisors and 

4 anterior molars. 

At 18 to 24 months 4 canines. 

At 24 to 30 months 4 posterior molars. 

General development is often delayed by neglect, im- 
proper feeding, sickness and other causes, such as 
heredity. 

DENTITION AND CARE OF THE TEETH 

Order of Appearance. — The first set of teeth are 
twenty in number, and the time of their appearance varies 
greatly in different children, but the following is the 
usual order of their arrival at various ages : 

At 6 months 2 teeth 

At 1 year 6 teeth 

At \y 2 years 12 teeth 

At 2 years 16 teeth 

At 2y 2 years 20 teeth 



124 HOW TO TAKE CARE OF THE BABY 

Causes of Delayed Dentition. — The chief causes of 
delayed dentition are rickets, malnutrition, or ill-health of 
some kind, but this is not always the case by any means, 
as some perfectly healthy children are very late in teeth- 
ing, and delayed dentition is sometimes -a family trait. 
Nursing infants are usually earlier than the artificially- 
fed ones in their dentition. 

Symptoms of Dentition. — It is a common mistake 
among mothers to attribute disturbances of the digestive 
tract in infants a few months old to teething, and to al- 
low the symptoms to go unchecked for this reason ; one 
fallacy being a widespread belief that diarrhea is a 
favorable condition during dentition. Teething is very 
seldom responsible for these conditions among healthy 
bottle-fed or breast-fed children. These, as a rule, cut 
their teeth without any inconvenience whatever. In a 
few, dentition will be accompanied by very slight symp- 
toms, such as loss of appetite, irritability and restless- 
ness, slight rise in temperature about 100° to 101° F., 
slight diarrhea, occasional vomiting, and less than the 
usual gain in weight. One or more of these symptoms 
may be present, and the child is noticed to drool and put 
his fingers in his mouth. 

Proper Treatment. — The mouth should be carefully 
examined, and if the gum is found to be swollen and in- 
flamed, that part should be gently rubbed with the finger 
three or four times a day. This simple measure often 
relieves the pain and symptoms ; but care must be taken 
to wash the hand carefully before inserting a finger in 
the baby's mouth. If the baby is breast-fed, he should be 
given an ounce of water before nursing, and the nursing 
period shortened; if he is bottle-fed, dilute the usual 
formula one-quarter to one-half with water. This should 
be continued until all unfavorable symptoms have sub- 
sided. 

Care of Teeth. — Until the age of two years a child's 



A MOTHER'S GUIDE 125 

mouth and teeth should be carefully washed two or three 
times a day by means of a piece of absorbent cotton 
twisted around a toothpick, or the little finger, and dipped 
into a solution of boric acid. After the age of two years, 
a soft toothbrush and castile soap should be used. When 
a child is three years old, his teeth should be examined 
at least once a year by a dentist. 

Permanent Teeth. — The permanent teeth appear as 
follows : 

The first molars (4) at 6 years. 
The incisors (8) at 7-8 years. 
The bicuspids (8) at 9-10 years. 
The canines (4) at 12-14 years. 
Second molars (4) at 12-15 years. 
Third molars (4) at 17-25 years. 

It is astonishing what little attention is paid to decayed 
teeth in children. Defective teeth affect the health of the 
entire body. Decayed or irregular teeth interfere with 
proper mastication. The pus, which is absorbed from de- 
cayed teeth, poisons the system, followed by nervous dis- 
turbances due to pain, indigestion and anemia. Decay- 
ing teeth act as* a breeding ground and distributing center 
for bacteria, which cause infectious diseases. 

Above all, mastication must be encouraged. Without 
proper mastication, the teeth soon begin to decay, solely 
from want of use. The food must therefore be of such a 
nature that it can not be swallowed without mastication. 

Most children do not nurse after the ninth month. 
Then is the time to give them a piece of toasted bread and 
butter after the nursing or after the bottle, twice a day. 
Children will gnaw and suck the toast, and this action 
induces the flow of saliva, which digests the starchy food. 
True mastication, however, does not take place until 
the first molars appear, about the fourteenth month. At 
two and a half years of age, when a child should have 



126 HOW TO TAKE CARE OF THE BABY 

its full set of temporary teeth, it can eat any food which 
adults are accustomed to. 

The meals should not terminate with concentrated or 
easily fermentable carbohydrates, which stick about the 
teeth, such as bread and jam, marmalade, sweet milk 
puddings, or other foods containing a large amount of 
sugar. However, if these things are eaten, they should 
be followed by fresh fruit. An apple is best for this 
purpose. 

The pathological craving for excess of sugar results 
from restricting the diet to pap. Ninety-five to a hun- 
dred per cent, of children, at the age of five or six years, 
have diseased teeth and the average number of diseased 
teeth in each mouth is about nine. At fourteen years, 
even the permanent set of teeth begins to decay, so that 
less than fifteen per cent, of children at that age are free 
from dental caries. 

Not many years ago, it was supposed that dental caries 
was a constitutional disease and markedly hereditary, but 
now it is known to be almost entirely the result of im- 
proper diet. The food must be of such a consistency as 
to demand mastication and the meal must be finished so 
as to leave the mouth clean. 

Foods can be divided into two groups: First, those 
which cling about the teeth and leave the mouth unclean ; 
and, secondly, those which are cleansing in their nature. 
In the first group we include all starchy and sugary foods, 
which have no fibrous element, such as sweet crackers, 
biscuits and cakes, bread with marmalade, jam, or honey, 
new bread without crust, bread soaked in milk, puddings, 
oatmeal and milk, preserved fruits, chocolates and candy 
of all kinds. Among the liquids we include cocoa, choco- 
late and milk. These foods are not harmful in moderate 
amounts, except when taken at the end of a meal. When 
taken as the sole food for a meal, they do not contain ma- 
terial of the right consistency for proper mastication. 



A MOTHER'S GUIDE 127 

In the second group we have the cleansing foods, such, 
as fish, meat, bacon, poultry, uncooked vegetables, such 
as lettuce, cress, radishes, celery. Cooked vegetables are 
cleansing to a less degree than uncooked vegetables. 
Other articles are stale bread, toasted bread, twice baked 
bread, pulled bread and cheese, fresh fruits and butter. 
Of the liquids we have soups and beef tea. 

Nothing should be allowed between meals. The habit 
of taking candy of any kind, or crackers and milk be- 
tween meals or before going to bed is injurious to the 
teeth for the reasons just mentioned. 

It is impossible to give adequate directions for feeding 
children even of the same age, as they vary so much in 
their tastes and idiosyncrasies and their constitutional 
tendencies. Children need all kinds of food, and in suffi- 
cient quantities. They often prefer one kind of food to 
the exclusion of others ; some care to eat nothing but meat, 
others make their meals exclusively of cereals or veg- 
etables. Both of these dietaries are wrong. Children 
require an abundance of all these materials. As a rule 
their diet is deficient in fats. Many children do not care 
for the fat of meats or for butter, which makes it hard 
to find some form of fat that will be acceptable. Cream, 
the fat of ham or bacon, vegetable oils, nut oils, should all 
be given a trial. 

No two meals should be alike. Some slight change 
should always be made. Warmed over dishes, smoked 
and salted meats, thick and rich gravies should be 
avoided. Every child is really a law unto himself, and 
it will require time, patience and judgment on the part 
of the mother to furnish the child with those articles of 
food best suited to his special requirements. 

N. B. — At two years, a child can eat an apple after it is 
peeled and the core removed. At three years, he can eat 
an unpeeled apple, but the core must be removed. 



128 HOW TO TAKE CARE OF THE BABY 

VACCINATION 

As a precaution against smallpox, every child should 
be vaccinated as early as possible, i. e., during the first 
year. Vaccination should never be delayed, except in 
cases of severe illness or malnutrition. When properly 
carried out with sterile hands, vaccine, and instruments, 
there is scarcely any danger. 

The site of vaccination is a matter of choice, but for 
the sake of convenience, in dressing and undressing, the 
leg seems to be the best place for an infant. 

A red pimple is noticed on the third or fourth day, 
and a day later a small blister is seen, which enlarges 
during the next three or four days to about one-third of 
an inch in diameter ; it is gray in color and is depressed 
in the middle. The blister dries up, forming a crust, 
which drops off in a week or two. About the eighth day 
a bright red inflammation of the skin around the blister 
is noticed, which disappears in a few days. 

Occasionally, about the ninth or tenth day, there may 
be a rash somewhat resembling that of measles or scar- 
let fever. 

About a week after vaccination, the child may be some- 
what restless, and have a little fever with loss of appetite 
for three or four days. 

CIRCUMCISION 

This small operation is strongly to be advised when- 
ever the foreskin is very tight or very long, and in every 
case when it can not be pulled back with ease. The 
mother or nurse should pull the foreskin back two or 
three times a week after giving the bath and wash the 
underlying parts, as a white, pasty material will accumu- 
late and cause irritation, which later is apt to lead to 
self-abuse. This irritation may also be the cause of bed- 



A MOTHER'S GUIDE 129 

wetting, night terrors and sleeplessness. A tight foreskin 
is sometimes responsible for convulsions on account of 
the difficulty in passing the water, and if the latter is 
accompanied by much straining, this may cause prolapse 
of the rectum, i. e., the protrusion of the lower part of 
the bowels or hernia. The operation is very simple and 
attended with very little danger. 

THE CRY 

Necessity for Crying. — At birth it is absolutely nec- 
essary for an infant to cry, in order that air may enter 
the lungs. He should be made to do so by slapping him 
on the buttocks. 

A baby should cry every day for a few minutes, for by 
crying the lungs are kept expanded. (See chapter on 
Exercise.) 

The Cry of Health and Illness. — It is not an easy 
matter to distinguish between the cries, but a mother or 
nurse, who is constantly with a baby, will usually learn 
to tell the difference between the cry of illness or pain 
and the usual cry in health. The latter is a strong, loud 
cry, and the child gets red in the face. The cry of pain 
is also strong and loud, but is not continued for long, and 
is accompanied by other evidences of distress, such as 
drawing up the legs, and wrinkling the forehead. 

The cry of illness is feeble and whining, and the child 
shows irritability when disturbed. 

The cry of hunger is prolonged and fretful, but not 
very loud. 

The cries of temper or of a habitually spoiled child 
are very much alike, strong and violent, and cease as 
soon as he gets what he wants. In these cases he should 
be allowed to cry it out, and no harm will result if he is 
in good health. 

Crying at Night. — When a child cries at night, see 



130 HOW TO TAKE CARE OF THE BABY 

that his hands and feet are warm, and examine his diaper, 
and change it if necessary. 

A well baby seldom or never cries solely because of a 
wet or soiled napkin, unless his buttocks are sore ; and if 
the crying is repeated or prolonged, the cause is usually 
some digestive disturbance. It is then advisable to give 
a laxative at once, and to reduce the strength of the food 
the next day. 

Tears. — An infant does not shed tears until the age 
of three or four months. Once the flow of tears has been 
established, their disappearance in crying during any sick- 
ness is not a favorable sign. On the other hand, their re- 
appearance is an indication of improvement. 

KISSING AND PLAYING WITH BABIES 

Kissing. — The kissing of an infant on the mouth 
should never be permitted, under any circumstances, by 
either adult or child. Diphtheria, tuberculosis and syphilis 
have often been communicated in this manner, for even 
healthy adults often have the germs of these diseases, and 
although they may never suffer from them, they can 
communicate them to a baby. Children suffering from 
contagious diseases in their earliest stages often transmit 
the disease by kissing. 

Infants ought never to be kissed by any one, except 
on the forehead, and even that should very seldom be 
permitted. 

Playing with Babies.— To play with, or amuse an 
infant under the age of six months is actually injurious, 
and may be the means of making him nervous and irrita- 
ble. Even such slight amusements as swaying a baby, or 
rocking him, all tend to stimulate the rapidly growing 
brain, and are harmful for this reason. 

Even after the age of six months, it is wiser to let an 



A MOTHER'S GUIDE 131 

infant amuse himself, as he will soon learn to do, if left 
alone. When constant efforts are made to amuse a child, 
he is apt to become nervous and fretful, to sleep badly, 
and to suffer from indigestion. He should never be 
played with immediately before bedtime at any age. 

The practice of allowing young babies and children to 
be present at any celebration can not be too strongly con- 
demned. The gratification of showing off the baby and 
seeing him admired is not worth having at the expense 
of his nerves and health. 

Children of Nervous Parents. — The children of 
nervous parents need to be especially guarded against any 
excitement ; they should have quiet surroundings, and see 
very few people. Some children have, undoubtedly, a 
tendency to nervousness, but this can be overcome as 
they grow older by careful and intelligent management. 

Older Children. — Children should never be fright- 
ened, nor should they have harrowing tales told to them. 
As soon as they are able to run about, all their amuse- 
ments should be out-of-doors as much as possible. Romp- 
ing and all exciting games should be confined to the early 
part of the day, so as not to interfere with their sleep at 
night. Too frequent children's parties, especially when 
indigestible or rich food is given, are not to be encouraged. 
Parties should be in the daytime only. The practice of 
keeping children up late at night is most injurious. 

TOYS 

Selection of Toys. — In buying toys for infants, care 
must be taken not to select anything that can be swal- 
lowed, as most children have a natural instinct to put 
everything in their mouths. For young babies of about 
six months of age, rubber rattles, animals and dolls are 
the best, as they are smooth and can be easily washed. 



132 HOW TO TAKE CARE OF THE BABY 

No toys covered with wool or hair, or with loose pieces 
that can be swallowed or put in the ear or nose, or with 
sharp points to injure the eyes, or paint to come off, 
should be chosen for a baby. 

Undesirable, also, are those that can be broken into 
bits, or those that would be apt to frighten a child with 
sudden noises or movements. 

All toys must be carefully washed before giving them 
to a baby, and the washing should be frequently repeated 
afterward. 

Simple Toys the Most Desirable. — The toys that 
give the most pleasure are the simplest ; and this is true 
of both infants and older children. Elaborate mechanical 
contrivances fail to please children for long. They soon 
tire of them because nothing is left to their imagination. 

One Toy at a Time. — One simple toy at a time will 
give a child more opportunity to develop his own re- 
sources for amusement than a large number, which only 
bewilder him. As soon as he is old enough, he should 
be taught to put away one toy when he takes out another, 
and to keep all those not in use neatly in a closet. 

Toys for Older Children. — For older children the 
best toys are the ones which give them an opportunity 
for using their faculties and imagination in such measure 
as they develop. Toys like blocks, toy-soldiers, engines, 
picture-books, dolls, small sets of dishes, beads to string, 
and pictures to paint are always sources of enjoyment. 
Where it is possible, a box of sand from which different 
shapes can be made, will give children a great deal of 
pleasure. 

BAD HABITS 

Below are mentioned some habits often seen in young 
children, which, if not corrected, may result in serious 
harm. 



A MOTHER'S GUIDE 133 

The Pacifier. — The pacifier, or rubber nipple, is en- 
tirely unnecessary, and should never be allowed. Its pro- 
longed use is harmful, and is apt to be followed by : 

Thick, misshapen lips. 

Irregular teeth. 

Deformed palate. 

Adenoid growths, from constant irritation. 

Infection, as it is never clean, and if it is passed around 
from one child to another, it may carry the germs of 
whooping cough, diphtheria, etc. 

Thumb-sucking. — Some children are also addicted 
to sucking their fingers, or any objects they can seize. 
This habit is easily remedied by folding a piece of card- 
board about six inches broad around the elbows, so that 
they can not be bent. Secure the edges with adhesive 
plaster, then fold a piece of cheesecloth or old linen 
around the cardboard and fasten the linen above and be- 
low the elbow to the sleeve by means of safety-pins. As 
the child can not bend its arms, it can not suck its fingers 
or other objects. Special mits can also be worn over the 
hands. 

Masturbation. — Masturbation is the habit of irri- 
tating the genitals. This is done in various ways, by 
touching them with the fingers, by rubbing the thighs 
against each other, and by rubbing the genitals against 
the leg of a chair or table. During the act the child's face 
becomes flushed and afterward perspiration may be no- 
ticed on the forehead and face. This is followed by 
drowsiness and the child may go to sleep. 

Children addicted to this habit show nervous symp- 
toms, they are restless, irritable, do not sleep well, lose 
their appetite, and become anemic. 

Treatment. — In infants, the use of thicker diapers 
that will keep the legs well apart is often sufficient. Older 
children must be watched carefully during the day, and at 



134 HOW TO TAKE CARE OF THE BABY 

night when going to bed. If thigh-rubbing is persisted in, 
a small pillow can be placed between the knees, and fas- 
tened there. 

MILK IN INFANTS' BREASTS 

New-born infants frequently have a liquid resembling 
milk in their breasts. This must be severely let alone, and 
it will disappear. The practice of squeezing it out often 
causes abscesses, and must on no account be permitted. 

ACCIDENTS ! 

Foreign Bodies Swallowed. — Should a child show 
signs of choking after swallowing too large a morsel of 
food, or "swallow the wrong way," as it is sometimes 
called, lift him up by the legs with the head hanging 
down, and give him a few sharp taps on the back with 
the palm of the hand. This will dislodge the food. When 
pins, buttons, coins, etc., are swallowed do not give a ca- 
thartic, as the article will be hurried through the stomach 
and bowels with a possibility of causing serious injury. 
If left alone, mucus from the stomach and bowels will 
collect around the article and make its passage smooth 
and harmless. If this accident occurs in an infant, give 
the same food as usual, and if an older child give more 
cereals, mashed potatoes, etc., for a few days. Examine 
every stool carefully for the article. 

Burns and Scalds. — When the burn is slight, there 
is redness, pain and tenderness of the skin, which is not 
destroyed in any way. The best treatment in these cases 
consists in the application of wet dressings of gauze or 
old linen soaked in a solution of bicarbonate of soda 
(cooking soda), a heaping teaspoonful of soda to the pint 
of water. Boric acid solution is also efficacious. The 
dressings should be kept wet continuously with either of 



A MOTHER'S GUIDE il33 

tKese solutions to prevent their adhering to the burnt sur- 
faces and to relieve the pain. 

In very severe and extensive burns, it may be found 
necessary to place the child in a tubful of water at blood 
heat 98° F., until the arrival of the physician. When the 
burns have begun to heal, and the discharge to disappear, 
they may be dressed every day or two with sterile or clean 
boric acid ointment, one teaspoonful to an ounce of vase- 
line. This should be spread thickly on gauze or linen and 
the dressing secured by a few turns of a bandage. 

Wounds. — Wounds and cuts should be attended to 
at once. Above all they must be kept clean, and should 
be washed at once in warm water with some absorbent 
cotton or other soft material. 

Deep, punctured wounds, from nails, broken glass, 
splinters, etc., require thorough opening out and cleaning 
by a physician, or lockjaw may develop. While waiting 
for his arrival, wash the wound with Dioxogen and 
bandage a wet compress over it. When there is much 
bleeding, place a piece of absorbent cotton or clean linen 
over the wound and apply firm pressure with the thumb 
or finger, until the bleeding stops and the cotton adheres. 
Then apply a light bandage. 

Nose Bleed. — Ice cold water, sniffed up the nostrils 
often stops bleeding. Cold compresses held over the 
nose and the back of the neck may help. If this does not 
stop it, plug the bleeding nostril with a piece of absorbent 
cotton, using a match or bit of wood to push it in. If this 
does not answer, compress the lower part of the nose be- 
tween the thumb and forefinger for a few minutes. The 
child should not blow its nose for some hours after the 
bleeding has stopped. 

Foreign Bodies in Nose. — Compress the empty nos- 
tril with a finger and get the child to blow its nose ; in this 
way most objects will be expelled. If not successful send 
f 05 £ physician. 



136 HOW TO TAKE CARE OF THE BABY 

In the Ear. — No attempt should be made to remove 
objects in the ear, unless they can be easily seized with 
the fingers. It is better to await the arrival of a physician, 
as damage may be done to the canal or the drum. 

In the Eye. — Rubbing the eye makes matters worse. 
If tears collect in the eyes, wipe them toward the inner 
side. Lay the child on a bed or table, separate the eyelids 
with both hands, and let a second person drop some warm 
water from a piece of cotton or linen on the eyeball, or let 
the child use an eyecup or put its face in a basin of clean 
water and then open and shut the eye repeatedly. 

An eyestone, which can be obtained at any drug store, 
is often useful in removing objects from the eye. 

Bruised Fingers. — Apply iced or very hot com- 
presses, and bandage the fingers tightly. 

Stings of Insects.— Apply a few drops of ammonia, 
or a compress soaked with witch hazel or alcohol. 

Sunburn. — Apply cold cream or talcum powder; 
or, if severe, compresses soaked with witch hazel, or alco- 
hol diluted with an equal amount of water. 

CONVULSIONS 

Convulsions in infants are not at all uncommon. They 
are symptoms brought on by irritation of the brain or 
nervous system. Although very alarming, they seldom 
leave any permanent ill-effects. 

Causes. — Disturbances of digestion are the most 
frequent causes. 

The next most frequent cause is rickets. 

Convulsions also occur at the onset of acute febrile dis- 
eases, such as pneumonia, scarlet fever, etc. 

Whooping cough, especially in young infants, is nearly 
always accompanied by convulsions. 

Local irritation, such as burns, tight foreskin, etc., may 
bring on convulsions. 



A MOTHER'S GUIDE 137 

Convulsions from teething or worms are very rare 
indeed. 

Symptoms. — As a rule a convulsion comes on with- 
out warning. The child becomes unconscious, the eyes 
vacant and fixed, or rolled up, the face becomes pale, the 
hands are clenched, and the muscles of the face, arms and 
body begin to twitch. The child breathes feebly, the 
forehead is cold and wet, and the lips and finger tips may 
turn blue. The convulsion may last from a few seconds 
to many minutes. After the attack the child is very weak 
and prostrated. One convulsion is apt to be followed by 
others. 

Treatment. — In all cases a physician should be sent 
for at once. When the convulsion is due to indigestion, 
rickets, whooping cough, or local irritation, the child 
should be placed immediately in a hot bath. The tempera- 
ture of the water should not be over 105° R, or as hot as 
can be comfortably borne by the mother's arm. If mustard 
is at hand, dissolve a tablespoonful in a cup and add it to 
a small tub of water or to six inches of water in a large 
bath-tub. Hold the child in the water from five to ten 
minutes, meanwhile gently rubbing his body and limbs. 
Put a small towel dipped in cold water on his head and 
forehead. After the bath dry him gently but quickly, put 
him to bed wrapped in warm blankets, and keep him 
warm by the use of hot water bottles, then give him 
an enema or colon irrigation with warm soap suds. 

If the convulsion occurs in the course of some illness 
where there is high fever, put a cold compress on the 
child's head and gently sponge the body and limbs with 
cool water. Place a hot water bottle near the feet if they 
are cold, but do not put too much clothing over the child. 

In all cases, a good dose of castor oil should be given 
after the bath or sponging, after the child recovers con- 
sciousness. 

After Treatment. — Only water should be given for 



138 HOW TO TAKE CARE OF THE BABY 

the next three or four hours, and for the next twenty- 
four hours the child should have no other food excepting 
broths, barley water, or milk greatly diluted. His regular 
diet must be resumed very gradually. 

COMMON DISEASES OF CHILDHOOD 

The following diseases are described for the con- 
venience and benefit of mothers and nurses who happen 
to be in the wilds or in uncivilized countries, where 
proper medical advice can not be obtained without great 
delay. Those living in civilized communities should on 
no account attempt to treat these diseases themselves. 

RICKETS 

This is a chronic disease due to faulty nutrition which 
chiefly affects the bones, and occurs in infants, especially 
between the ages of six months and two years. 

Causes. — The great majority of cases are due to 
prolonged feeding on proprietary foods with an insuffi- 
cient amount of fresh milk. Less frequent causes are 
fresh milk or food containing an insufficient amount of 
fat or cream. In rare cases, it can be attributed to exces- 
sive fat or cream in the food, or to prolonged use of 
boiled or sterilized milk. 

Early Symptoms. — The earliest symptoms are fret- 
fulness, pallor, sleeplessness, and sweating of the head; 
the pillow is constantly wet, and the hair at the back of 
the head is worn off from restlessness. 

Later, the abdomen becomes enlarged ; this is known as 
"pot-belly" ; the child is backward in development ; either 
it can not sit erect, or its teething is delayed or it is late 
in walking. 

Later Symptoms. — When this condition is neglected, 
many bones become enlarged and deformed, and, as the 



A MOTHER'S GUIDE 139 

bones are very soft, a child often becomes bow-legged. 
The head, the wrists and ankles are enlarged and the 
chest is deformed. There may be convulsions and child- 
crowing. The child is usually constipated, and is subject 
to frequent colds and intestinal troubles. 

Treatment. — Stop all proprietary foods, condensed 
milk, etc., and give good, fresh, whole milk in formulas 
suitable to his age. Add albumen water, fresh eggs, 
broths and beef-juice to the diet if the child is old enough. 
Give cod-liver oil emulsion, or the juice of fried bacon. 
See that the child has plenty of fresh air, and keep him 
out-of-doors as much as possible. Attend to the regu- 
larity of his bowels, and give suitable cathartics and 
enemas, if necessary. 

SCURVY 

Scurvy is a disease which occurs principally between 
six and eighteen months of age, but is most common be- 
tween the seventh and tenth months. It usually attacks 
the knee and ankle joints, causing great pain. 

Causes. — The chief cause, in most cases, is the ex- 
clusive use of proprietary foods without the addition of 
fresh milk. A prolonged use of pasteurized, boiled, or 
sterilized milk or condensed milk is also a frequent cause. 

Earliest Symptoms. — The earliest symptom noticed 
is that the child cries when moved or taken up, or the 
diaper is changed, or when any one touches the bed or 
bedclothes. The knee and ankle joints may be swollen 
and are very tender, but are not hot nor red. The disease 
may attack any joint in the body, but the knee is the one 
most commonly affected. The mother is liable to mistake 
scurvy for the result of an injury, rheumatism, or for 
paralysis, as a child suffering from this disease is un- 
willing to move because of the pain caused thereby, but 
the paralysis is only apparent, not real. Rheumatism is 



140 HOW TO TAKE CARE OF THE BABY 

practically unknown in children under two years 
of age. 

I Other Symptoms. — The position of a child with 
scurvy is often very characteristic. He will lie on his 
back with the knees slightly drawn up and widely sep- 
arated. If he has any teeth, the gums may be swollen 
and purplish in color and will bleed easily. The child 
looks pale and anemic and has little appetite owing to the 
pain caused by sore gums. 

There may be bluish marks resembling bruises on dif- 
ferent parts of the body, especially the legs. In some 
cases there is bleeding from the nose and bowels, 
i Treatment. — The child must have fresh cow's milk, 
and also the juice of sweet oranges or prune juice, begin- 
ning with one-half ounce three times a day, one hour be- 
fore feedings, and increasing the amount in a few days 
to one and a half ounces three times a day, irrespective of 
the age. If he is old enough he should be given in addi- 
tion mashed or baked potatoes and apple sauce once a day. 

If this treatment is carried out, marked improvement 
will be noticed in a few days, and a cure will be effected 
in two or three weeks in the milder cases. 

PNEUMONIA 

Causes. — Pneumonia is an inflammation of the lungs 
and is brought about by exposure to cold and wet, or 
whenever the vitality of the body is lowered, as in malnu- 
trition or marasmus, or it may follow a neglected or 
severe bronchitis, or as a sequence to one of the con- 
tagious diseases, as measles, etc. 

Symptoms. — There is rapid and shallow breathing, 
often accompanied by a grunt at each expiration, which 
is very characteristic. There is a hacking dry cough, 
which may be very distressing. The face is flushed, the 
lips are blue and sometimes we may see fever sores (or 



A MOTHER'S GUIDE 141 

herpes) on them. The tongue is coated, the skin dry and 
the urine scanty. The child is drowsy and may be deliri- 
ous. The temperature varies from 102° to 105° F. 

Treatment. — The child must be put to bed at once 
in a light and airy room, and the temperature kept be- 
tween 55° and 60° F. The windows must be opened 
enough to admit fresh air, but without a draft. The bed 
clothing should be very light, just enough to keep the 
child's body and feet warm ; a great deal of harm is often 
done by overloading the bed with blankets and quilts, 
which make the child restless and irritable and deprive 
him of sleep and rest. If he perspires about the head and 
neck, he has too many clothes over him. The diet should 
be fluid only. His usual bottle of milk must be diluted 
with one-quarter to one-half water. He should have 
plenty of cool, but not iced water to drink between 
feedings. 

If breast-fed, he should be nursed as before and should 
get plenty of water between nursings. His bowels must 
be kept open, for it is important for them to move freely 
every day. It is well to give a good dose of calomel at 
the commencement of the disease and subsequently an 
enema of soap suds if necessary. 

Sponging. — If the child is very restless, he should 
be sponged from head to foot, with a mixture of half 
alcohol and half tepid water, taking about .fifteen minutes 
to go over the whole body, and sponging one part at a 
time, leaving the rest of the body covered. This sponging 
should be repeated every four hours if the child is very 
restless. In addition an ice cap should be laid on the head. 

If the child is quiet, but the temperature is high, i. e., 
over 104° F., put an ice cap on the head and give plenty 
of fluids to drink, and leave him undisturbed. Wet com- 
presses may be used instead of the ice cap, but must be 
wrung out carefully so as not to wet the pillow and the 
bedding. 



142 HOW TO TAKE CARE OF THE BABY 

Most children do not require medicines, unless compli- 
cations arise, which should be attended to by the family 
physician. 

THE SICK ROOM IN CONTAGIOUS DISEASES 

Quarantine. — The room selected for a child suffer- 
ing from any contagious disease should be, if possible, sit- 
uated on the top floor, as there he can be more rigidly 
isolated, and the risk of infection for other members of 
the family will be much less. 

Only the attending nurse and the physician should be 
allowed in the room; other members of the family must 
not be permitted to enter. Any children in the family 
who have been exposed to the contagion at the beginning 
of the illness should be quarantined in another part of 
the house until the period of incubation is past ; those not 
exposed should be sent away from home. 

Room and Furnishings. — The room should be large, 
light, and well ventilated, and it will be better to have an- 
other smaller adjoining room set apart for the nurse to 
change her clothes in, before going out to take her daily 
exercise, and also in the event of a second nurse being 
necessary. An open fire in the sick room is very desira- 
ble, when possible, also green shades at the windows so 
that the light may be subdued if the patient's eyes are 
weak. All carpets, curtains, draperies, pictures, orna- 
ments and upholstered furniture should be removed, and 
nothing allowed to remain that can not be burned or 
washed and thoroughly fumigated afterward. A per- 
fectly bare floor without any rugs is best. 

Care of Room. — The temperature should be regu- 
lated^ to 68° F. by day, and from 60° to 65° at night. 
Ventilate very frequently, covering the patient with extra 
blankets while doing so, or better, if the child can be 



A MOTHER'S GUIDE 143 

i 

properly shielded from drafts, keep the windows wide 
open day and night, except when changing the bedclothes 
or other coverings. The room should be kept very clean 
by wiping with damp cloths, which must be burned im- 
mediately after, the woodwork and furniture should be 
wiped daily with a solution of bichloride of mercury in 
the proportions of one to five thousand. One tablet of 
seven and one-third grains and dissolved in two and one- 
half quarts of water will make this solution. 

Precautions. — The meals for patient and nurse must 
be left outside the door on a tray for the nurse to take in 
afterward, and after use, all the utensils should be placed 
in boiling water for five minutes before being taken 
down-stairs. 

If the case is one of scarlet fever or diphtheria, the 
nurse should use an antiseptic gargle and nasal spray to 
guard herself from infection. She should wear a cap 
completely covering her hair while in the sick room, and 
all her clothes should be of cotton and washable. She 
must change every article of clothing in the adjoining 
room, and wash her face and hands thoroughly before de- 
scending for her daily walk. 

Care of Linen. — In place of handkerchiefs for the 
patient, old pieces of muslin or gauze should be used for 
the purpose of cleansing the nose or mouth, and immedi- 
ately burned. If there is no fire in the room, a small box 
or bag should be kept to put them in and this sent down 
to the furnace. 

All clothing and bedding both for patient and nurse 
should be soaked in carbolic solution, one to twenty, and 
then boiled in it for two hours before going to the laun- 
dry. The practice of hanging sheets steeped in carbolic 
is not advisable, as carbolic acid poisoning has been 
known to result from it. 

The chief thing to be remembered in connection with 



144 HOW TO TAKE CARE OF THE BABY 

disinfection is scrupulous cleanliness, for carbolic and bi- 
chloride are effectual only when they follow a rigorous 
use of soap and water. 

Selection of Toys and Books. — All toys and books 
for use during the child's illness, especially if it be scarlet 
fever, must be of a character that can be burned when 
the child is convalescent. A goodly supply of cheap toys 
and magazine pictures will be most welcome, for when 
the little patient is not very ill he will sleep better if 
propped up in bed occasionally with a warm dressing 
sacque on, and allowed to amuse himself a little, but in 
the case of measles, he must not read or strain his eyes in 
any way. 

Fumigation.— After measles or diphtheria, it is not 
necessary to disinfect so thoroughly as after scarlet fe- 
ver ; all linen and clothing should be treated in the same 
manner, but a thorough cleaning and fumigation of the 
room with formalin or sulphur is all that is necessary; 
formalin is the best disinfectant for a room, and the 
generator can be rented with full directions for use from 
almost any drug store; all cracks in the room must be 
previously stopped with cotton, and larger crevices pasted 
with paper. The room should be left overnight under 
fumigation and then thoroughly aired. 

Fumigation After Scarlet Fever. — A child conva- 
lescent from scarlet fever must receive a bichloride bath, 
one to five thousand strength, from head to feet, before 
he leaves the room; he should then be wrapped in 
blankets and taken into another room, where he is given 
a bath of soap and hot water. He must wear clothes that 
have not been in the sick room during his illness. 

The room and its contents should receive a thorough 
fumigation in the following manner: The mattress and 
pillows must be either thoroughly disinfected by steam 
or where this is not possible, they must be burned. All 
blankets and bedding should be boiled in carbolic solu- 



A MOTHER'S GUIDE 145 

tion, washed, and hung in the sun. All toys, books, pa- 
pers, rugs, etc., that have been used should be burned. 
The room and all the furniture in it must be thoroughly 
washed, and then fumigated with formalin, and left for 
twenty-four hours. After this the ceiling should be re- 
kalsomined and the walls repapered, or if they are 
painted, washed with bichloride solution of one to two 
thousand strength. (One tablet of seven and one-third 
grains to one quart of water.) 

CONTAGIOUS DISEASES 

I shall describe only briefly the more common con- 
tagious diseases met with in children; such as scarlet 
fever, measles, whooping cough, diphtheria, mumps, etc. 

A correct diagnosis is sometimes very difficult, even 
for a physician. For instance, a scarlatinal rash on the 
abdomen may be called a simple stomach rash ; and with- 
out laboratory examination, a mild form of diphtheria 
of the tonsils may be mistaken for a simple follicular 
tonsilitis. 

The onset in all of these diseases is nearly the same, 
and the mother should not waste time trying to find out 
what is the matter with the child, but should at once send 
for a physician. 

When to Send for a Physician. — It is a safe rule to 
make, that a physician should be sent for whenever there 
is a rash, a sore throat, difficulty in swallowing, a cough 
with difficult breathing, or whenever the child is drowsy 
or apathetic, or restless, irritable, and has loss of appetite. 

The temperature is often no guide; in many cases of 
diphtheria it is not much over 101° F. Nursing infants 
under six months of age who are properly looked after 
are almost immune from contagious diseases, with the 
exception of whooping cough. 



146 HOW TO TAKE CARE OF THE BABY 

Whooping Cough 

In the early months of life, whooping cough is by far 
the most fatal of the contagious diseases. The period of 
incubation varies from one to two weeks. At first the 
disease can not be distinguished from an ordinary cough, 
but after ten to fourteen days the whoop develops in 
older children. For this reason, a child with a cough 
should never be allowed near a young infant indoors or 
out, nor sleep in the same room. 

Symptoms." — During the paroxysms of coughing, 
the characteristic whoop is noticed, there is great diffi- 
culty in taking breath, the face gets red, and there is great 
prostration afterward. The food is often vomited. 
Young infants do not whoop, but cough and hold their 
breath, and turn very blue in the face, and they may have 
convulsions. 

Treatment. — There is no specific remedy for whoop- 
ing cough ; a physician can, however, administer a vaccine 
or prescribe sedatives and greatly relieve the patient. 
The child should have plenty of fresh air day and night. 
There are many preparations in the market claiming to 
relieve and shorten the course of the disease, which may 
be of use in some cases. A sea voyage shortens the dura- 
tion of the cough by several weeks. A properly fitted ab- 
dominal belt will often give relief. 

Contact with other children should be avoided until the 
cough has completely disappeared, as the whoop often 
returns if the child catches cold. 

A physician should decide when a child can be allowed 
to go among other children. 

A child suffering from whooping cough should wear a 
white band on the arm or across the chest, marked 
"Whooping Cough/' whenever he goes out in any park or 
playground. 



A MOTHER'S GUIDE 147 

Chicken Pox 

This is a mild contagious disease which appears about 
two weeks after exposure. 

Symptoms. — There is a slight fever in most cases, 
100°-102° F., and the child does not feel so well as usual. 
The rash appears on the first day, comes out in crops and 
is most abundant on the trunk. We notice widely scat- 
tered pimples in various stages of development, and vary- 
ing greatly in size ; red spots, elevated pimples, little blis- 
ters, and later, blackish crusts. A few are always found 
on the scalp, and one or two in the mouth, the latter being 
a very characteristic location. There may be itching of 
the skin. 

Treatment. — No special treatment is necessary. 
Keep the child quiet in bed for a couple of days, and 
empty the bowels. The undergarments should be of cot- 
ton, as woolen ones increase the itching. Carbolated 
ointment rubbed on the skin will allay the itching. 

The child should be isolated until the rash has com- 
pletely disappeared. 

If the child is allowed to scratch the eruption, scars 
may be left permanently in the skin. 

Diphtheria 

The germs of diphtheria attack the mucous membranes 
of the body, especially those of the nose and throat, and 
cause severe poisoning of the system. 

Symptoms. — When a child is exposed to the dis- 
ease the symptoms may be delayed for several days. 
Children who have been exposed to the disease should be 
frequently examined by their physician. 

The most frequent sites of attack are the tonsil, larynx 
and nose. On the tonsil we notice at first small grayish 
patches, which, becoming larger, join one another. 



148 HOW TO TAKE CARE OF THE BABY 

Patches extend toward the uvula and other parts of the 
throat, and when they spread to the larynx they cause 
great difficulty in breathing and speaking. 

Any continued bloody mucous discharge from the nose 
not due to a blow, or fall, or other injury, should be con- 
sidered a case of diphtheria until the contrary has been 
proved by examination at a laboratory. 

The onset of symptoms is very slow, the temperature 
is often not above 101°-102° F. There is loss of appe- 
tite, apathy and restlessness. There may be slight pain in 
swallowing. 

Treatment. — Antitoxin should be administered as 
early as possible. Delay in its use makes the outlook very 
bad. In doubtful cases it should always be given, as it 
can do no harm. 

Quarantine. — The length of time in quarantine must 
be decided by the physician in charge. 

As a precautionary measure, every member of the 
household should be treated with antitoxin. 

Measles 

Symptoms. — Measles appears about ten to fourteen 
days after exposure. It is a very contagious disease and 
may be carried by clothing and other objects. 

The onset begins with redness and running of the eyes, 
which are also sensitive to light, discharge from the nose, 
and a dry cough. The child appears to have caught a se- 
vere cold. There is loss of appetite and fever, which may 
rise to 103° or 104° F. The third or fourth day a rash 
appears on the face and behind the ears. It consists of 
small, dark-red, raised spots, which often form groups, 
and lasts about three or four days. There may be itching 
of the skin. 

Treatment. — The child should be given a hot bath 
and then be put to bed at once in a well ventilated room, 



A MOTHER'S GUIDE 149 

with the shades drawn down to darken it. An older child 
can wear a green celluloid eye shade such as clerks often 
use, and which will be found very soothing. The eyes 
should be bathed every three hours in the day with a 
warm boric acid solution, one teaspoonful to one pint of 
water. Only fluid diet should be given while the tem- 
perature is above normal. The bowels must be kept open. 
For restlessness or high temperature see treatment under 
Pneumonia. When there is much itching of the skin, 
cold cream or cocoa butter rubbed on the body and limbs 
will relieve it greatly. If the cough is very severe, treat 
as under Bronchitis. 

Quarantine. — The child should stay in bed three 
days after the temperature has returned to normal, and 
should be quarantined for two weeks thereafter. 

The most frequent complication of measles in infants is 
pneumonia. 

German Measles 

This is a contagious disease, which resembles measles, 
but is not nearly so severe. It makes its appearance in 
from one to three weeks after exposure, and lasts only 
from three to five days. 

Symptoms. — The child becomes drowsy, has slight 
fever and a sore throat. The rash appears on the first or 
second day of the illness; it begins on the face and 
spreads over the rest of the body. It fades so rapidly 
that the face may be clear before the arms and legs are 
covered with it. The glands at the back of the neck are 
often swollen. 

Treatment. — The child should be kept in bed on a 
fluid diet for a few days, and his bowels should be at- 
tended to. No other treatment is necessary in most cases. 

Quarantine. — The child should be isolated for a 
week after the disappearance of the rash. 



150 HOW TO TAKE CARE OF THE BABY 

Scarlet Fever 

The period of incubation varies from a few hours to 
seven days. This disease is carried by clothing and other 
objects that have been in contact with the patient. Such 
articles have been known to cause an outbreak after a 
lapse of years. 

Symptoms. — There is loss of appetite, often vomit- 
ing, constipation, high fever, 103°-105° F., the breathing 
is hurried, and there is restlessness, sleeplessness and 
headache. The throat is inflamed and sore and there is 
difficulty in swallowing. The tongue is coated, and red at 
the tip and edges. The rash appears after about twenty- 
four hours first on the neck and chest and spreads rap- 
idly all over the body. It consists of small red points, 
sometimes isolated, at other times blended into a dull, red 
flush; it lasts from five to seven days. After this the 
skin begins to peel off in small flakes, especially notice- 
able on the palms and soles. The peeling may last any- 
where from two to six weeks, during which time strict 
quarantine should be maintained. It is most contagious 
while the skin is peeling. 

Treatment. — The most common complications, in- 
flammation of the kidneys and of the ears, are much to be 
dreaded, and for this reason a physician should be in con- 
stant attendance. Before his arrival the child should be 
put to bed (see chapter on Sick Room). Only fluid diet 
should be given, preferably milk, until the fever has 
dropped ; then cereals and a vegetable diet are permitted. 
No meat or animal food whatever, including meat soups, 
meat broths, fish, eggs, etc., should be allowed until three 
or four weeks after the temperature has been normal. 

Mumps 

This is a contagious disease which affects the salivary 
glands, and appears from one to three weeks after ex- 
posure. 



A MOTHER'S GUIDE 151 

Symptoms. — The child feels sick, chilly, drowsy and 
feverish. The temperature varies from 100°-103° F. A 
swelling soon appears below and in front of one ear, 
which pushes the lobe of the ear out, and feels doughy to 
the touch. There is also pain in moving the jaws. The 
other glands below the jaws may be swollen and the face 
is often distorted. Very often the gland below the other 
ear is also affected. The disease lasts about a week. 

Treatment. — The child should be put to bed and 
only fluid or semi-fluid diet given during the next few 
days. When the pain is severe, hot compresses applied to 
the parts will be found very soothing. In less painful 
cases, ordinary cotton batting bandages over the glands 
will suffice. 

Quarantine. — The child should be isolated for three 
weeks from the commencement of the disease. 

DISEASES OF THE SKIN 

A few of the more common diseases of the skin are 
described below. 

Eczema 

Eczema is characterized by inflammation and marked 
itching of the skin, which is thickened, moist, and shows 
crusts and fissures. Serum exudes and soon forms crusts. 
In children it usually appears on the face and scalp. 

The treatment is not very satisfactory, and takes a long 
time. The child's diet and hygiene must be attended to. 
As there are so many varieties of eczema, which are often 
mistaken for different diseases of the skin, it is best to 
obtain the advice of a physician. The eruption may with 
advantage be covered with a bland ointment, like Lassar's 
paste, which can be obtained from any drug store. Water 
must never be allowed to touch the eruption, but sweet oil 
used instead for cleansing purposes. 



152 HOW TO TAKE CARE OF THE BABY 

Eczema of Scalp, or Milk Crust 

This consists of yellow or gray crusts which matt the 
hair together, and occurs only in infants. The scalp 
should be soaked with an ointment made of vaseline con- 
taining five per cent, of resorcin. The hair should be cut 
short if it interferes with the application of the ointment. 
An old handkerchief or a piece of muslin should have 
some of the ointment spread on it and then tied over the 
child's head, so as to keep the crusts constantly moist. 
This should be repeated morning and evening for three 
or four days, when the scalp should be washed with soap 
and water, and the crusts removed with a fine tooth comb. 
Severe cases need to have this treatment repeated. 

Poison Ivy 

This is an inflammation of the skin marked by intense 
redness and blisters containing serum and pus and at- 
tended by itching or burning. It usually occurs on the 
hands and face after contact with poison ivy, and cer- 
tain medicinal substances. 

Treatment. — Soothing lotions should be used, such 
as solutions of sodium bicarbonate or boric acid. Some 
persons are at once relieved by dusting powders such as 
bismuth subnitrate, lead acetate, etc. 

Prickly Heat 

Excessive heat accompanied by profuse perspiration is 
responsible for this eruption, which occurs mostly upon 
the trunk and consists of small, bright red pimples and 
blisters which are crowded together but remain separate. 
There is itching, tingling or burning. 

Treatment. — Light clothing and frequent cold baths 



A MOTHER'S GUIDE 153 

are indicated. Cooling lotions or solutions of bicarbonate 
of soda or boric acid should be applied to the skin, fol- 
lowed by dusting powders, such as oxide of zinc, bis- 
muth, etc. 

Hives 

Hives is an inflammation of the skin, characterized by 
whitish or pinkish flattened or round elevations of the 
skin marked by intense itching or burning. The eleva- 
tions look exactly like mosquito bites or the sting of the 
nettle; they may remain isolated or become joined to- 
gether. Sometimes there is swelling of the underlying 
skin, especially about the eyelids. Ordinarily the inflam- 
mation lasts from a few hours to a few days. 

Hives may be caused by contact with certain plants or 
the bites of some insects or by certain articles of food, 
as shell fish, pickles, etc., and certain drugs, as quinine, 
copaiba, etc. The cause must be ascertained and re- 
moved. 

Treatment. — Bran baths often relieve the condition. 
Carbolated ointment applied to the worst spots will at 
once relieve the itching and burning. 

No matter what the cause, a cathartic should always be 
given. 

Scabies, or the Itch 

This is a contagious affection due to the presence of 
a parasite, which burrows under the skin, the favorite 
positions being between the fingers, at the elbows and 
between the thighs. The irritation causes itching all over 
the body, which soon shows scratch marks and excoria- 
tions. 

Treatment. — All clothing recently worn should be 
boiled or fumigated. All the affected parts of the skin 



154 HOW TO TAKE CARE OF THE BABY 

should be thoroughly rubbed morning and evening with 
sulphur ointment, one ounce powdered sulphur and four 
ounces lard, well mixed together. The symptoms will 
speedily disappear in a few days. 

Intertrigo 

Intertrigo is an intense redness of the skin and occurs 
when moist surfaces of the skin touch each other. The 
inflammation is caused mostly by neglecting to provide 
the child with clean, dry diapers, but it may be brought 
about by acid urine or stools, excessive perspiration and 
friction. The most frequent sites are between the but- 
tocks, between the thighs and in the folds of the groin. 

Treatment. — The parts must be kept dry with tal- 
cum powder or boric acid powder. The diapers must be 
changed as soon as they are wet. 

A quicker way is to leave off the diapers in a warm 
room and to expose the inflamed areas to the air for a 
few hours a day. 

Applications of zinc ointment or boric acid ointment 
are very healing. When these are applied no powder 
should be used. 

FOOD RECIPES 

Albumen Water. — Take the white of one fresh egg, 
divide it in several directions with a sharp steel knife, 
add half a pint of cold boiled water, and a pinch of salt. 
Shake thoroughly, or use an egg beater, and give it cold, 
either from the bottle or with a spoon. 

Rice Water. — Wash one heaping tablespoonful of 
rice, let it soak overnight, then add a pint of water and 
a pinch of salt. Boil for three or four hours, or until 
the grains of rice are quite soft. Water must be added 



A MOTHER'S GUIDE 155 

from time to time to keep the quantity up to a pint. 
Strain it through muslin. 

Barley Water. — Barley water from the grains is 
made in the same way, and in the same proportions, as 
rice water. 

When made from prepared barley flour, or Robinson's 
Patent Barley, a little cold water is added to one level 
tablespoonful. This is carefully stirred to make a very 
thin, smooth paste, and then poured into a pint of boil- 
ing water containing a pinch of salt. This should be 
boiled in a double boiler for thirty minutes, strained, and 
enough water added to bring it up to the original pint. 

Dextrinized Barley Water. — After making barley 
water and straining it, allow it to cool to about 100°F., 
and add one teaspoonful of Cereo to it, stir and allow 
to stand for ten minutes, then cool it and mix it with the 
milk formula. In some feeding cases dextrinized barley 
water is more easily digested than plain barley water. 

Oatmeal Water. — One tablespoonful of oatmeal to 
one pint of water, boil three hours and add enough water 
to make a pint. 

Wheat Water. — This is made exactly the same as 
the oatmeal water and in the same proportions. 

Barley, oatmeal, rice, or wheat water can all be made 
from the prepared flours, or from the grains, and all are 
made in the same proportions, and in the same way, as 
the recipes given for rice and barley water. 

Gruels or Jellies From Rice, Oats, Wheat or Barley. 
— These can be made in the same manner, and either 
from the grains or the flour, but the proportions are from 
two to four level tablespoonfuls of the flour to a pint of 
water. When the grains are used, two tablespoonfuls 
are taken, and soaked overnight, then cooked for four 
hours. They should be strained, and when milk is to 
be added, it must be stirred in directly after removing 
the gruel from the fire. 



156 HOW TO TAKE CARE OF THE BABY 

Beef Juice. — There are two ways of making fteef- 
juice. The first is to take one-half pound of round steak, 
cut thick. Broil it slightly, then press out the juice with a 
lemon squeezer or meat-press and add a little salt. The 
second method is to have the round steak finely chopped, 
and put it in a covered jar, then pour in enough cold 
water to cover it and add salt. Cover the jar and stand 
it on ice for six hours or more, shaking it from time 
to time. Empty the jar into a piece of cheesecloth and 
strain. This method is not quite so palatable, although 
children do not seem to object to it, and it has the ad- 
vantage of being more nutritious and much more eco- 
nomical. 

Beef-juice can be warmed slightly by pouring it in a 
small cup, and then placing this in a larger one contain- 
ing warm water. It should, however, not be warmed 
enough to coagulate the albumen. 

Mutton, Chicken, Veal and Beef Broths. — Take one 
pound of meat free from fat, cut in small pieces, cover 
with one pint of cold water, add a pinch of salt, and 
allow it to simmer for three or four hours, adding water 
as necessary. It should cook down to about half a pint. 
Strain and when cold, remove the fat. It can be given 
hot, or in some cases cold, in the form of jelly. 

Scraped Beef. — A rare piece of sirloin steak is 
slightly broiled. Then, with a dull knife, this is scraped 
or shredded, taking only the pulp for use. From a tea- 
spoonful to a tablespoonful may be given, with a little 
salt. 

Prune Pulp. — Cook the prunes slowly in a porcelain 
saucepan with a little water until they are quite soft. 
Then strain or rub them through a coarse sieve. 

Whey. — Take one pint of fresh cow's milk and warm 
it, but not above about 100°F. Add two teaspoonfuls 
of Fairchild's essence of pepsin, or liquid rennet. Stir 



A MOTHER'S GUIDE 157 

for a minute, then allow it to stand until firmly jellied, 
then break up the curd, with a fork, and strain off the 
whey through muslin, then pasteurize it and put it in 
the ice-box. One pint of milk will yield about eleven 
ounces of whey. Since the introduction of protein milk, 
whey is used very little in difficult feeding cases. 

Junket. — This is for older children and is made in 
the same manner as whey, except that two teaspoonfuls 
of sugar can be stirred in with the rennet, and that va- 
nilla, cinnamon or grated nutmeg may also be added as 
a flavoring. As soon as the mixture is firmly coagulated, 
place it in the ice-box to get thoroughly cold. Do not 
stir it nor strain it. 

Coddled Egg. — Into a saucepan of boiling water a 
fresh egg is placed without removing the shell. The 
water is immediately removed from the fire, and the egg 
left in it for five minutes. The white should then be of 
a jelly-like consistency. 

Bran Biscuits. — Take: 

1 pint of flour, 

1 quart bran (straight), 

12 tablespoonfuls molasses, 

1 teaspoonful baking soda, 

1 teaspoonful salt, 

1 generous pint of milk. 

Mix and bake in muffin rings. These will make about 
twenty rings. 

These bran biscuits are very efficacious in overcoming 
constipation in nursing mothers. Usually two biscuits 
a day will be sufficient. 

Corn-Meal Mush. — 1 quart of water. 

1 teaspoonful of salt. 

1 pint of granulated corn-meal. 

Add the salt to the water, and when boiling, sprinkle 
in the corn-meal, slowly stirring all the while. Boil rap- 



158 HOW TO TAKE CARE OF THE BABY 

idly for ten minutes, then push the kettle over a slow- 
fire to cook for two hours. Serve warm with milk. 

This will help to increase the flow of milk in nursing 
mothers. 

MEASURES 

The following list of measures will be found useful 
when making up food formulas or giving medicines. 

1 ounce of liquid equals 2 tablespoonfuls. 

Or equals 4 dessertspoonfuls. 

Or equals 8 teaspoonfuls. 

Or equals 8 drams. 

1 tablespoonful equals 2 dessertspoonfuls. 

Or equals 4 teaspoonfuls. 

1 dessertspoonful equals 2 teaspoonfuls. 

A cup or tumbler equals J4 pint. 

An ordinary wineglass equals 2 ounces. 

For Measuring Sugar. — 1 heaping tablespoonful of 
cane sugar equals 1 ounce. 

3 level tablespoonfuls of milk sugar equal 1 ounce. 

COMMON REMEDIES 

Some children require smaller and others larger doses 
of cathartics than those given below, but the following 
amounts should produce at least two good movements six 
or eight hours after administration. 

Castor Oil: 

Under 3 months old, y 2 to\ teaspoonf ul. 

From 3 to 6 months old, 1 to 2 teaspoonfuls. 

From 6 to 9 months old, 2 to 3 teaspoonfuls. 

From 9 to 12 months, 4 to 6 teaspoonfuls. 

Older children, 1 to 2 tablespoonfuls. 

When children object to castor oil, it can be made pala- 
table in two ways : 



A MOTHER'S GUIDE 159 

1. Stir it with double the amount of orange juice ; or 

2. Mix it well with an equal amount of sirup of sarsa- 
parilla and add a dash of vichy. After cooling on the ice, 
shake well and give at once. 

Calomel. — Under 1 month old, 3/10 grain. 

From 1 to 3 months old, }i to % grain. 

After this age % grain may be added for every three 
months of age, making the doses, 1 grain at 1 year, and 
2 grains at 2 years ; but more than 2 grains should rarely 
be given at any age. The tablets should be dissolved in 
water before administration, and it is better to divide the 
dose, giving 1/10 or }i or 34 grain tablets every 10 to 15 
minutes, until the entire amount has been taken, than to 
give it all at once. 

Milk of Magnesia. — Phillips' Milk of Magnesia. 
Dose y 2 to 1 teaspoonful, given in the ten o'clock bottle 
at night. 

This is the best laxative for infants under one year old, 
and can be used for months. 

Citrate of Magnesia. — Dose : Half a tumblerful early 
in the morning, for children over two years of age. It 
is a good substitute for castor oil, when preceded by a 
dose of calomel, and has the advantage of being pleasant 
to take. 

Sirup of Ipecac or Wine of Ipecac. — Dose : One tea- 
spoonful, repeated if necessary. Used chiefly in spas- 
modic croup, as an emetic. No nursery should be with- 
out it. It can also be given when a child eats any highly 
indigestible food, and it is desirable to empty the stomach. 

Brown Mixture. — This is an excellent cough mix- 
ture, universally employed. As it contains a small 
amount of paregoric, mothers and nurses are cautioned 
not to give too large doses, nor to continue this remedy 
longer than necessary. 

The doses are as follows : a child 6 months, 10 drops ; 
1 year, l5 v drops ; 18 months, 20 drops ; 2 years, 25 drops ; 



160 HOW TO TAKE CARE OF THE BABY 

3 years, 30 drops; 4 years, 40 drops; 5 years, 1 tea- 
spoonful. 

The dose can be repeated every 2 or 3 hours, up to 4 or 
5 doses a day. 

Rhubarb and Soda Mixture. — This mixture is recom- 
mended as a mild laxative for children of all ages. The 
dose is a teaspoonful for every year of age, i. e., one-half 
teaspoonful at 6 months, 3 teaspoonfuls at 3 years, etc. It 
can be given two or three times a day one-half hour be- 
fore meals, until good results are obtained. 

Compressed Liquorice Powder. — Stirred up in milk, 
this powder is an excellent mild laxative for older chil- 
dren. Dose for a child three years old, one-half teaspoon- 
ful ; for a child five years old, one teaspoonful. 

Dobell's Solution. — This antiseptic solution, diluted 
with one or two parts of warm boiled water, can be used 
as a spray for colds in the nose or throat. Mixed with 
three parts warm water it can be employed as an efficient 
gargle. 

INJECTIONS, SUPPOSITORIES, AND IRRIGA- 
TIONS 

Caution Against Their Prolonged Use. — Although 
the use of any of these remedial measures for constipa- 
tion should never become a fixed habit, as serious harm 
may result from their prolonged use, still it is important 
that a mother should be familiar with the different modes 
of administering them, as in many minor ailments one or 
the other is often the only remedy required. 

Suppositories and Enemas. — In a case of ordinary 
constipation a soap suppository can be used. It is made 
by cutting out a small piece of castile soap as thick as a 
lead pencil, and about an inch long. A gluten suppository 
is equally good, and can be obtained at most drug stores. 



A MOTHER'S GUIDE 161 

A sweet oil enema of an ounce or two, depending on 
the child's age, will also be found useful. 

If a more efficient enema is required, mix one table- 
spoonful of glycerine with three of sweet oil. 

The enemas are best given with a small rubber bulb 
syringe, the rubber point should be well oiled before in- 
serting it and the solution injected slowly. 

Whenever suppositories or enemas are used, the child's 
buttocks must be held together for ten or fifteen minutes 
in order to get proper results. 

Colon Irrigation. — When there is much colic, flatu- 
lence and a distended abdomen, or at the onset of acute 
indigestion or illness, it is advisable to give a colon irriga- 
tion. This is done by means of a No. 20, 22, or 24 French 
catheter attached to a fountain syringe, which should be 
suspended not more than two or three feet above the 
child's buttocks. 

Use water at about 100°F., or as hot as can be comfort- 
ably borne by the hand, and add one teaspoonful of table 
salt to every pint used. The reason for the addition of 
salt is, that it is less irritating than the use of plain water. 
The amount to be injected varies for different ages, but 
enough must be used to clean out the bowels thoroughly. 
One quart will be sufficient for an infant under six 
months old, one and a half quarts for a child one year old, 
and two quarts for a child under four years of age. Chil- 
dren will not retain these amounts, for the greater part of 
the water is expelled during the irrigation. In some cases 
soda bicarbonate is used instead of the salt. 

How to Give a Colon Irrigation. — -The child must be 
laid on his back on the bed, with a rubber sheet and a 
thick pad under him. On the floor should be a basin or 
pail, so arranged that the water will all run into it from 
the sheet. The catheter should be oiled its entire length 
with vaseline, and a little water allowed to run through 



162 HOW TO T^LKE CARE OF THE BABY 

it into the basin to insure its being at the proper tempera- 
ture, then raise the child's legs * bend the thighs, and sepa- 
rate them enough to allo\> ,ie catheter to be inserted. 
Never use any force in doing this, as carelessness may 
cause injury. If the catheter is correctly inserted and as 
soon as the water distends the bowel, it will slide in with- 
out any resistance, often for its entire length, but no at- 
tempt must be made to push it with any but the lightest 
pressure. Very often the catheter is forced out with the 
water which is expelled from the bowel. It should then 
be inserted again, until the return flow is clear. 

When about half the amount has been given, discon- 
nect the catheter, leaving it in the rectum, and allow the 
water from the bowels to run out. Pressure on the lower 
part of the abdomen will assist in forcing the water out. 
When the flow ceases, connect the catheter again to the 
fountain syringe, and proceed as before. 

DON'T 

Don't wean a baby because the mother's milk looks 
pale, like diluted skimmed milk. It often looks that way. 

Don't neglect cold hands and feet, as an attack of indi- 
gestion, pneumonia, etc., may follow. 

Don't swaddle the baby with clothes, so that he per- 
spires, as he is then very apt to catch cold. 

Don't forget to attend to the regularity of the bowels. 

Don't play with the baby after his feeding, nor excite 
him at any time, especially before going to bed at night. 

Don't make any sudden or unusual noise in the pres- 
ence of the baby. 

Don't take up the baby every time he cries; you will 
spoil him. 

Don't feed the baby every time he cries ; you will upset 
his digestion. 



A MOTHER'S C "IDE 163 

Don't allow friends or strangers to kiss your baby, and 
don't kiss your own baby <^n the mouth. 

Don't allow any one witi. :ough near your baby. 

Don't forget that fresh air is essential to a baby's 
health. 

Don't neglect a "little" diarrhea. 

Don't forget to give a child a good dose of castor oil 
whenever he is upset, and then dilute his food for the 
next few feedings. 

Don't forget that the first sign of a disturbed digestion 
is often restlessness at night. 

Don't coax the baby to take his food ; it is poison when 
he does not want it ; let him get hungry and wait for the 
next feeding. 

Don't keep on giving a child the same food when you 
know it is disagreeing with him. 

Don't give a vomiting baby a rich milk mixture con- 
taining much cream, or sugar, or proprietary foods. 

Don't give a cold bottle to a baby. 

Don't begin any change of food by giving large quanti- 
ties or by making it strong. 

Don't forget to give plenty of water to the baby when 
the napkins are stained a yellow or brick-red color. 

Don't follow your friend's advice ; consult your physi- 
cian. 

Don't forget that it is easier to avoid trouble than to 
cure it. 

Don't forget to keep a note-book recording the weight, 
the feeding, and any illnesses. 

Don't leave poisons or drugs anywhere within reach of 
a child. 



INDEX 



INDEX 

PAGE 

Accidents 134 

Additional food during first year 62 

Adenoids Ill 

Airing 14 

Airing, Indoor 14 

Albumen water 154 

Appetite, Loss of 73 

Appetite, Peculiarities of 76 

Articles for preparing food 44 

Artificial feeding 39 

Bad habits 132 

Barley water 55, 62, 155 

Barley water, Dextrinized 155 

Bath, How to give a 9 

Bath, Bran, soda, starch, salt, sponge or mustard 11, 12 

Bathing 8 

Bathing, Articles for 9 

Bed, The baby's V. 3 

Bedding, Care of 3 

Bed wetting 119 

Beef juice 62, 156 

Bottle, Drinking from 37 

Bottle, Nursing 45 

Bottle, How to warm a 46 

Bowels and bladder, Training of 118 

Bran biscuits 157 

Breast pump , 34 

167 



168 INDEX 

^ , PAGE 

Broths 156 

Bronchitis 106 

Bruised fingers 136 

Burns and scalds 134 

Buttermilk 65 

Calomel 99, 159 

Castor oil, Constipation increased by 99 

Castor oil, Doses 158 

Cathartics, Warning against 95 

Chapin dipper 44 

Chicken pox 147 

Circumcision 128 

Clothing , 4 

Clothing of older children 6 

Clothing, List of, for young baby 6 

Colds and their causes 103 

Colds, Prevention of 103 

Colds, Chronic 104 

Colic and wind 85 

Constipation 95 

Constipation in nursing baby 96 

Constipation in bottle-fed baby 96, 97 

Constipation in older children 97 

Contagious diseases 145 

Convulsions 136 

Croup kettle 105 

Croup, Spasmodic 108 

Cry, The 129 

Cough, Remedy for 107 

Cows, Care of 42 

Cow's milk, Composition of 40 

Cup, Teaching to drink from 38 

Development 120 

Diarrhea, In nursing infant 90 



INDEX 169 

PAGE 

Diarrhea, Severe, in nursing infant 91 

Diarrhea, In bottle-fed infant 91 

Diarrhea, Severe, in bottle-fed infant 92 

Diarrhea, Summer 92 

Diarrhea, Complications of 94 

Diet from 12 to 15 months 68 

Diet from IS to 18 months 68 

Diet from 18 months to 2 years , . . . 69 

Diet from 2 to 3 years of age 70 

Diet from 4th to 10th year 71 

Diphtheria 147 

Diseases of the skin 151 

Don't 162 

Douches, Cold 12 

Earache 109 

Eczema 151 

Eczema of scalp, or milk crust 152 

Egg, White of 63 

Egg, Coddled 157 

Enemas 160 

Exercise 16 

Eyes, Care of the 13 

Fat, Necessity of 58 

Feeding, Artificial 39 

Feeding, Mixed 25, 31, 36 

Feeding schedules 54 

Feeding, General directions for 59 

Feeding, Position during 59 

Feeding, Waking for 60 

Feeding, Time allowed for 60 

Feeding, Intervals between 61 

Feeding, Indications for changing 80 

Feeding during illness ■ , 81 

Feeding after illness SI 



170 INDEX 

PAGE 

Feeding, Night 56, 60 

Feeding in hot weather, Rules for 94 

Foot covering 5 

Forbidden articles of food 77 

Foreign bodies swallowed 134 

Foreign bodies in nose, ear or eye 135, 136 

Formula, How to select a 47 

Formula, Increase of 48 

Formula, Preparation of suitable 50 

Formula, Amount in 53, 56 

Fumigation 144 

Gargle (see Dobell's solution) 160 

Garments, Outer 5 

Garments, Night 5 

Genitals, Care of 13 

Glands, Enlarged Ill 

Gruels 62, 155 

Height of children , . . 122 

Hiccough 108 

Hives 153 

Increasing the food, Indications for 48 

Increasing the food, Indications for not 49 

Indigestion 80 

Indigestion from overfeeding 81 

Indigestion from excess of fat 82 

Indigestion from excess of sugar 83 

Inj ections 160 

Intervals, Lengthening of 61 

Intertrigo 154 

Irrigation, Colon 161 

Jaundice 115 

Junket 157 



INDEX 171 

PAGE 

Kissing babies 130 

Laxative for young infants 97 

Lifting a baby 7 

Lifting older children 8 

Malnutrition and marasmus 100 

Mammala, a desiccated milk 83 

Masturbation 133 

Meals, Regular hours for 72 

Measles 148 

Measles, German 149 

Milk, Herd 40 

Milk from Holstein or Jersey cows 41 

Milk, Care of 41, 43 

Milk, Different grades of 50 

Milk, Whole 51 

Milk— Sugar 52 

Milk, Skimmed . . 59 

Milk for older children 72 

Milk, Condensed 83 

Milk in infant's breasts 134 

Milk of magnesia 159 

Mother's milk, Substitute for 39 

Mumps 150 

Mustard plaster 106 

Napkins, Care of 7 

Napkins, Discoloration on 80 

Night terrors 113 

Nipples and breasts, Care of 22, 39 

Nose bleed I 135 

Nursery, The 1 

Nursery, The, Ventilation of 1 

Nursery, The, Heating of 2 

Nursery, The, Temperature of 2 



172 INDEX 

PAGE 

Nursery, The, Lighting of 3 

Nursing 21 

Nursing, Conditions prohibiting 4 21 

Nursing, Schedule for 24 

Nursing, Abnormal conditions in 26 

Nursing, Signs of overfeeding in 27 

Nursing, Too quick 27 

Nursing, Too rich milk in 27 

Nursing, Scanty milk in 29 

Nursing, Poor milk in ; . . . 30 

Nursing mother's guidance, Rules for 23, 24 

Oatmeal jelly ^ 98 

Oatmeal water 98, 155 

Olive oil 58 

Orange juice 63, 98 

Outings, Rules for 15 

Pacifier, The 133 

Patent foods 84, 85 

Pasteurization 66 

Peptonization, Directions for 65 

Peptonized milk 65 

Playing with babies 130 

Pneumonia 140 

Pneumonia, Sponging in 141 

Poison ivy 152 

Preparation of a baby's food 44 

Prickly heat 152 

Protein milk 63 

Prune juice 98 

Prune pulp 156 

Quarantine * . . • 142 



INDEX 173 

PAGE 

Recipes, Food 154 

Reducing food, Indications for 49 

Remedies, Common 158 

Rice water 154 

Rickets 138 

Russian oil 99 



Scabies, or the itch 153 

Scales for babies 122 

Scarlet fever 150 

Scraped beef 156 

Scurvy 139 

Sickroom in contagious diseases 142 

Sleep 17 

Sleeplessness, its causes 19 

Sprue or thrush 110 

Stables 41 

Sterilization 66 

Stings of insects 136 

Stools, Normal 77 

Stools, Effect of proprietary foods on 78 

Stools, Effect of drugs on 78 

Stools, Curds in 78 

Stools showing excess of fat 78 

Stools showing excess of protein 78 

Stools showing excess of sugar 79 

Stools, Blood in 79 

Stools from inactive liver 79 

Sugars, milk, cane or malt 52 

Suppositories 95, 160 

Syrup of ipecac 108, 159 

Teeth, Care of 123 

Teething 123 

Temperature, The 115 



174 INDEX 

PAGE 

Thirst from heat 49 

Throat, Examination of 116 

Thrush or sprue 110 

Thumb sucking 133 

Thunderstorms, Effect of 44 

Tonsils 112 

Top milk 50, 51, 56 

Toys 131 

Underwear 4 

Urine, Retention of 114 

Vaccination 128 

Vomiting, Causes of 86 

Vomiting in nursing infants 86 

Vomiting in bottle-fed infants 87 

Vomiting from overfeeding 87 

Vomiting from too rapid feeding 87 

Vomiting from too frequent feeding 87 

Vomiting from playing with babies 87 

Vomiting from tight binder 87 

Vomiting from excess of fat >. 87 

Vomiting from excess of sugar 88 

Vomiting from chronic constipation 88 

Vomiting from habit 88 

Vomiting from errors in diet 88 

Vomiting, General treatment for 89 

Vomiting from acidosis 89 

Vomiting from pyloric stenosis 90 

Vomiting requiring physician's attention 89 

Weaning, Reasons for early 36 

Weaning in summer 37 

Weaning, Sudden 37, 39 

Weaning at 12 months 38 



INDEX 17S V 

PAGE 

Weaning, Selection of formula in 38, 47 

Weight, Loss of 38 

Weight of average normal child 120 

Weights and measures 158 

Wet-nurse, Selection of 33 

Wet-nurse, Treatment of 34 

Wet-nurse's own infant 35 

Wet-nursing 32 

Wet-nursing, Difficulties of 32 

Wet-nursing, Indications for 32 

Wheat water 155 

Whey 156 

Whooping cough 146 

Worms 112 

Wounds 135 



NOTES 



NOT E S 



NOTES 



NOTES 



PRESS NOTICES OF 1st EDITION 

From Leading Medical Journals 



This is an excellent little book and for its size surprisingly 
complete. In fact it is crammed full of needful advice and in- 
struction and the author seems to have eliminated all irrelevant 
material. The appearance of the book is attractive, the form 
convenient and the arrangement logical. It is one of those books 
of which we have often said that there can not be too many, and 
unlike some of which have appeared, this book of Dr. Tweddell's 
has been so carefully and sanely done that we can recommend 
it heartily to all mothers and predict a wide field of usefulness 
for it. 

December, 1911. The Archives of Pediatrics {New York). 



This is a wholly admirable, simple little book, which does 
not aspire to teach medicine and may be safely recommended to 
any Mother or Child's nurse. 

December, 1911. The American Journal of Obstetrics 

and Diseases of Women and Children 
{New York). 



Mothers, and prospective mothers, often ask a physician to 
recommend them some small book dealing with the nursing and 
feeding of infants, and with the management of some of the 
more common ailments incident to child life. The present vol- 
ume is well adapted for this purpose; it is written in clear and 
simple language, and the directions are complete and safe. Most 
books of this kind tell a great deal too much, and are often as 
dangerous as they are useful; this little book is an agreeable 
exception. 
February 10th, 1912. Medical Record {New .York). 



PRESS NOTICES (Continued) 



The strongest essential, to our mind, of a book primarily ad- 
dressed to lay people, is the insistence of a strict definition between 
the fields of activity of the physician and the mother or nurse. This 
has been maintained by the author admirably. In other particu- 
lars, also, the book is highly commendable. The text is suffi- 
ciently comprehensive and we have noted no important omissions. 
The chapter on infant feeding, probably the most important in 
the book, is a clear and sensible exposition of the percentage sys- 
tem. We are glad to note that the author is not a warm advocate 
of top milk. It would by no means be offering an insult in 
recommending this book to many physicians. The text con- 
tains information about the care of infants which does not fall 
into the scope of text-book or even of hospital training and only 
comes to those long in the school of experience. 

February, 1912. American Journal of Surgery 

{New York). 



The author has succeeded in producing a book which gives 
simple, clear and complete directions, easily to be understood by 
the average American mother. The book can be cordially com- 
mended to the hands of every intelligent mother. 

May 4th, 1912. New York Medical Journal. 



PRESS NOTICES (Continued) 



Brief, concise and authoritative manual by the Assistant 
Physician of the Babies' Hospital Dispensary, New York, giving 
most approved principles and practice in the care, nursing, arti- 
ficial feeding, common diseases and digestive disorders of chil- 
dren. On feeding it replaces the earlier standard work by 
Holt, which in its last edition is not so complete or up to 
date. 

Extracts from the American Library Association's Book List, 
a guide to the best new books, adapted for State use by the 
League of Library Commissions, May, 1912. 



This little book of 182 pages is of decided value. It is in- 
tended primarily for the nursing mother and possesses a wealth 
of information very well condensed into clear and readable Eng- 
lish. It is not intended to supplant the Doctor as the family ad- 
visor or physician, but to give directions to the mother in order 
that she may take care of her baby in a reasonable and proper 
manner, as well as to point out the various danger points of in- 
fancy. 

As a guide for the mother it is of distinct value and fulfils 
the purpose for which it was destined. 
May, 1912. The Post Graduate {New York). 



